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Can mechanical balloon dissection be applied to cleave fibrotic submucosal tissues? A pilot study in a porcine model.
- Source :
- Endoscopy; Aug2013, Vol. 45 Issue 8, p661-666, 6p
- Publication Year :
- 2013
-
Abstract
- Background and study aims: Removal of a lesion containing an ulcer scar is one of the most challenging applications of endoscopic submucosal dissection (ESD). The present study examined whether a novel balloon dissector could cleave fibrotic submucosal tissue beneath ulcer scars. Methods: Six pigs were studied. Endoscopic mucosal resection (EMR) with ligation was performed at 7 or 8 sites in the stomach for each animal; 4 weeks later, 23 sites with a visible scar were selected for submucosal dissection. The procedure involved first creating a submucosal fluid cushion (SFC) by injecting either saline mixed with mesna or pure saline. A slender, compliant balloon with a diameter of 8, 13, or 18mmwas inserted into the SFC. The balloon was unfolded and thrust forward to cleave the fibrotic submucosa over approximately 5cm. Results: Fibrotic submucosa was dissected within 90 seconds in 17 of 23 attempts. Isolating the ulcer scar from the muscularis with the SFC prior to balloon dissection and using a thinner balloon catheter both ensured a better dissection. Conclusions: The fibrotic submucosa underlying post-EMR scars can be dissected with the novel balloon dissector, although the technique is less effective in cases with no sign of lifting. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0013726X
- Volume :
- 45
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- Endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 89736079
- Full Text :
- https://doi.org/10.1055/s-0033-1344126