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Total buried bumper syndrome: A case study in transabdominal removal using a technique of endoscopic submucosal dissection.

ABSTRACT: Tube removal by endoscopic submucosal dissection using needle and insulation-tipped diathermic knives against buried bumper syndrome is a reliable, noninvasive and safe procedure.

SUBMITTER: Nakamura H

PROVIDER: S-EPMC6787815 | biostudies-other | 2019 Oct

REPOSITORIES: biostudies-other

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Total buried bumper syndrome: A case study in transabdominal removal using a technique of endoscopic submucosal dissection.

Nakamura Hajime H Kikuchi Shohei S Ohnuma Hiroyuki H Hirakawa Masahiro M Kato Junji J

Clinical case reports 20190903 10

Tube removal by endoscopic submucosal dissection using needle and insulation-tipped diathermic knives against buried bumper syndrome is a reliable, noninvasive and safe procedure. ...[more]

PMID: 31624631

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Project description:BackgroundFlexible endoscopes ability to manipulate the intestinal environment is limited. As a result, complex endolumenal procedures are often technically demanding and result in long procedure times, impacting institutional resources. Single- and double-balloon add-on endoscopic devices have been employed throughout the GI tract to facilitate tissue control e.g., small bowel enteroscopy, with recent reports suggesting a possible colonic utility for complex procedures e.g., ESD. Our objective was to objectively analyze the efficacy of a new double-balloon device in performing ESD.MethodsEx vivo-12 simulated colonic lesions were created in porcine rectum using a standard 40 mm diameter template. Two categories were evaluated, standard cap technique ESD and double-balloon assisted ESD with retraction (ESD-R). Cases were performed sequentially. In vivo-Six, 40 mm lesion ESD-R's were performed in a porcine model. The primary outcomes of this study were total procedure and dissection times.ResultsIn ex vivo studies, the median total procedure time with the double-balloon platform was significantly shorter than the traditional ESD technique (29 ± 18 vs. 57 ± 21 min, p = 0.03). In the in vivo studies, lesions were successfully removed in a mean time of 48 min, with a dissection time of 20 min with no significant complications. Balloon-clip retraction and specimen retrieval capabilities were used in all double-balloon assisted cases. After 6 cases, times were significantly shorter (ex vivo 47 vs. 17 min; in vivo 57 vs. 27 min).ConclusionsWe have demonstrated the development of a unique technical ESD method facilitated by a new double-balloon device. Ex and in vivo investigation demonstrated superiority of ESD-R over the conventional ex vivo method. The DB device provided increased stability, improved visualization and tissue traction, which significantly reduced dissection time. Such an approach may increase safety, improve patient outcomes, and may prevent unnecessary surgeries for benign conditions.

Dataset Information

Total buried bumper syndrome: A case study in transabdominal removal using a technique of endoscopic submucosal dissection.

Publications

Total buried bumper syndrome: A case study in transabdominal removal using a technique of endoscopic submucosal dissection.

Similar Datasets

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