1. Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection? (with Video)
- Author
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Wan Sik Lee, Jin Seok Jang, Weon Jin Ko, Bong Min Ko, Yunho Jung, In Kyung Yoo, Young Kwan Cho, Joo Young Cho, Sun Gyo Lim, Hee Seok Moon, Jae Young Jang, Seong Hwan Kim, and Gwang Ho Baik
- Subjects
Gastrointestinal tract ,medicine.medical_specialty ,business.industry ,Perforation (oil well) ,Gastroenterology ,Medicine (miscellaneous) ,Endoscopic mucosal resection ,Endoscopic submucosal dissection ,03 medical and health sciences ,0302 clinical medicine ,Electrical current ,In vivo ,030220 oncology & carcinogenesis ,Hemostasis ,Medicine ,030211 gastroenterology & hepatology ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Ex vivo - Abstract
Background/Aims: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model.Methods: In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed.Results: The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group.Conclusions: The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.
- Published
- 2021