Japan Digestive Disease Week 2022
International Session (Symposium)4 (JGES, JSGE, JSGS, JSGCS)
October 29, 9:30–12:00, Room 9 (Fukuoka International Congress Center 413+414)
IS-S4-3_E
Development of a compact stapler for flexible endoscope aimed at full-thickness closure in the field of gastrointestinal tract
- 1
- Endoscopy Division, National Cancer Center Hospital
- 2
- Division of Science and Technology for Endoscopy (Tsukiji), Group for Innovative Diagnostic and Therapeutic Device, Exploratory Oncology Research & Clinical Trial Center (EPOC), National Cancer Center
Objective.
We have been developing a compact stapler with tissue retractor (not yet approved by the Pharmaceuticals and Medical Devices Agency) for flexible endoscope to completely close ulcers after endoscopic resection. We decided to further develop this device to enable the closure of wall defect after endoscopic full-thickness resection (EFTR).
Methods
Acute animal experiments (porcine, 40 kg, under laparoscopy) were conducted to verify the efficacy and safety of the prototype device through repeated bench tests using excised porcine stomachs. The wall defect by EFTR (3 cm in diameter) was made on the gastric body, and full-thickness closure was attempted using this device.
Results.
The full-thickness closure was completed with no gap from the luminal side. The leak test showed no leakage and we confirmed to be feasible technically. Although CT imaging of the excised specimen demonstrated to remain staples within the gastric wall, the B-shaped molding of staples was not fully obtained.
Conclusion.
A compact stapler with tissue retractor for flexible endoscope, a closure device after EFTR, is under development; we aim to achieve the closure both of ulcer by endoscopic resection and of wall defect by EFTR.
We have been developing a compact stapler with tissue retractor (not yet approved by the Pharmaceuticals and Medical Devices Agency) for flexible endoscope to completely close ulcers after endoscopic resection. We decided to further develop this device to enable the closure of wall defect after endoscopic full-thickness resection (EFTR).
Methods
Acute animal experiments (porcine, 40 kg, under laparoscopy) were conducted to verify the efficacy and safety of the prototype device through repeated bench tests using excised porcine stomachs. The wall defect by EFTR (3 cm in diameter) was made on the gastric body, and full-thickness closure was attempted using this device.
Results.
The full-thickness closure was completed with no gap from the luminal side. The leak test showed no leakage and we confirmed to be feasible technically. Although CT imaging of the excised specimen demonstrated to remain staples within the gastric wall, the B-shaped molding of staples was not fully obtained.
Conclusion.
A compact stapler with tissue retractor for flexible endoscope, a closure device after EFTR, is under development; we aim to achieve the closure both of ulcer by endoscopic resection and of wall defect by EFTR.
- Index Term 1: stapler
- Index Term 2: full-thickness