Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection?
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Background/Aims: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting withsimultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopicsubmucosal 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 vivoporcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to themuscularis 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 inthe 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 layerinjuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred ineither group. Conclusions: The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding duringgastric and colorectal ESD in animal models.
Abstract
Background/Aims: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting withsimultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopicsubmucosal 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 vivoporcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to themuscularis 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 inthe 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 layerinjuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred ineither group. Conclusions: The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding duringgastric and colorectal ESD in animal models.
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