ASGE JGES Advanced ESD (On-Demand) | September 2022 OLESDSEPT22ADV-Bhatt New methods techniques and technologies for ESD

Bhatt New methods techniques and technologies for ESD

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Amit Bhatt, Director of ESD at the Cleveland Clinic, discusses new technologies and innovations in ESD (Endoscopic Submucosal Dissection). ESD is a procedure done through an endoscope, but it lacks the surgical principles of triangulation. Bhatt explores homemade traction solutions such as the clip + line method, which shows potential benefit in the esophagus. However, he acknowledges the limitations of these homemade methods.<br /><br />Bhatt then shares his journey of ESD training in Japan and the development of a traction device called ProdiGI™. This device is simple to use and provides continuous counter traction. Working with Medtronic Gastrointestinal, the device was refined into a single nitinol wire that can be flexibly positioned with the endoscope.<br /><br />He presents the initial multi-center experience of using the ProdiGI™ traction wire in colon ESD. The study assessed the efficacy, safety, and efficiency of using the traction wire. From the human results, it was found that the device achieved en bloc resection rates of 98.1% and R0 resection rates of 90.2% with a median deployment time of 2 minutes.<br /><br />Bhatt also mentions the use of a multi-knife technique, which reduces knife exchanges and costs. However, this technique currently lacks injection capability.<br /><br />In conclusion, Bhatt highlights the importance of new technologies and innovations in ESD to improve the efficacy and safety of the procedure. These advancements, such as the ProdiGI™ traction wire, show promise in enhancing traction and facilitating ESD procedures.

Keywords

ESD

Endoscopic Submucosal Dissection

traction device

ProdiGI™

nitinol wire

colon ESD

en bloc resection rates

R0 resection rates

multi-knife technique

new technologies