Endolifter, a new tool for safe and rapid submucosal endoscopic dissection

Abstract

Background: The effectiveness of endoscopic submucosal dissection (ESD) is similar to that of surgery in the treatment of early lesions. The technique requires a high level of technical skill. Training on biologic models and the mastering of accessories facilitate ESD. Aims: The aim was to evaluate the usefulness of the Endolifter in facilitating tissue exposure during ESD in an in vivo porcine model performed at the experimental surgery laboratory of the School of Medicine at the Universidad de São Paulo in Brazil. Material and method: A study with an experimental design employing an in vivo porcine model was conducted on 5 Yorkshire pigs weighing 20-25 kg. ESDs were performed using the Endolifter. Mucosal layer dissection was carried out with a dual knife and IT knife and all the endoscopic procedures were performed by a single expert endoscopist. Results: A total of 25 ESDs were performed, with a technical success rate of 100%. The mean dissection time was 12.34 min (range: 10.40-14.50 min) and the mean lesion size was 2.7 cm (range: 2.3-3.2 cm). There were no episodes of bleeding or perforations during the procedures. Conclusions: The Endolifter enables rapid and effective ESDs to be carried out. It is an applicable and easy-to-use device that can be manipulated by a single operator.

Keywords

• Endoscopic submucosal dissection
• Endolifter
• Hemorrhage
• Porcine model