Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model
Background and Aims. Three-dimensional (3D) rigid endoscopy has been clinically introduced in surgical fields to enable safer and more accurate procedures. To explore the feasibility of 3D flexible endoscopy, we conducted a study comparing 2-dimensional (2D) and 3D visions for the performance of eso...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/4051956 |
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| author | Kazutoshi Higuchi Mitsuru Kaise Hiroto Noda Go Ikeda Teppei Akimoto Hiroshi Yamawaki Osamu Goto Nobue Ueki Seiji Futagami Katsuhiko Iwakiri |
| author_facet | Kazutoshi Higuchi Mitsuru Kaise Hiroto Noda Go Ikeda Teppei Akimoto Hiroshi Yamawaki Osamu Goto Nobue Ueki Seiji Futagami Katsuhiko Iwakiri |
| author_sort | Kazutoshi Higuchi |
| collection | DOAJ |
| description | Background and Aims. Three-dimensional (3D) rigid endoscopy has been clinically introduced in surgical fields to enable safer and more accurate procedures. To explore the feasibility of 3D flexible endoscopy, we conducted a study comparing 2-dimensional (2D) and 3D visions for the performance of esophageal endoscopic submucosal dissection (ESD). Methods. Six endoscopists (3 experts and 3 trainees) performed ESD of target lesions in isolated porcine esophagus using a prototype 3D flexible endoscope under 2D or 3D vision. Study endpoints were procedure time, speed of mucosal incision and submucosal dissection, number of technical adverse events (perforation, muscle layer damage, and sample damage), and degree of sense of security, fatigue, and eye strain. Results. Procedure time and speed of mucosal incision/submucosal dissection were equivalent for 2D and 3D visions in both experts and trainees. The number of technical adverse events using 2D vision (mean [standard deviation], 3.5 [4.09]) tended to be higher than that using 3D vision in trainees (1.33 [2.80]; P=.06). In experts, 2D and 3D visions were equivalent. The degree of sense of security using 3D vision (3.67 [0.82]) was significantly higher than that using 2D vision (2.67 [0.52]) in trainees (P=.04), but was equivalent in experts. The degree of eye strain using 3D vision (3.00 [0.00]) was significantly higher than that using 2D vision (2.17 [0.41]) in trainees, but was equivalent in experts. Conclusions. 3D vision improves the sense of security during ESD and may reduce technical errors, especially in trainees, indicating the feasibility of a clinical trial of ESD under 3D vision. |
| format | Article |
| id | doaj-art-1a348196c5df4afea1994520d80951cb |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-1a348196c5df4afea1994520d80951cb2025-02-03T06:44:21ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/40519564051956Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal ModelKazutoshi Higuchi0Mitsuru Kaise1Hiroto Noda2Go Ikeda3Teppei Akimoto4Hiroshi Yamawaki5Osamu Goto6Nobue Ueki7Seiji Futagami8Katsuhiko Iwakiri9Department of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanDepartment of Gastroenterology, Nippon Medical School, Tokyo 113-8603, JapanBackground and Aims. Three-dimensional (3D) rigid endoscopy has been clinically introduced in surgical fields to enable safer and more accurate procedures. To explore the feasibility of 3D flexible endoscopy, we conducted a study comparing 2-dimensional (2D) and 3D visions for the performance of esophageal endoscopic submucosal dissection (ESD). Methods. Six endoscopists (3 experts and 3 trainees) performed ESD of target lesions in isolated porcine esophagus using a prototype 3D flexible endoscope under 2D or 3D vision. Study endpoints were procedure time, speed of mucosal incision and submucosal dissection, number of technical adverse events (perforation, muscle layer damage, and sample damage), and degree of sense of security, fatigue, and eye strain. Results. Procedure time and speed of mucosal incision/submucosal dissection were equivalent for 2D and 3D visions in both experts and trainees. The number of technical adverse events using 2D vision (mean [standard deviation], 3.5 [4.09]) tended to be higher than that using 3D vision in trainees (1.33 [2.80]; P=.06). In experts, 2D and 3D visions were equivalent. The degree of sense of security using 3D vision (3.67 [0.82]) was significantly higher than that using 2D vision (2.67 [0.52]) in trainees (P=.04), but was equivalent in experts. The degree of eye strain using 3D vision (3.00 [0.00]) was significantly higher than that using 2D vision (2.17 [0.41]) in trainees, but was equivalent in experts. Conclusions. 3D vision improves the sense of security during ESD and may reduce technical errors, especially in trainees, indicating the feasibility of a clinical trial of ESD under 3D vision.http://dx.doi.org/10.1155/2019/4051956 |
| spellingShingle | Kazutoshi Higuchi Mitsuru Kaise Hiroto Noda Go Ikeda Teppei Akimoto Hiroshi Yamawaki Osamu Goto Nobue Ueki Seiji Futagami Katsuhiko Iwakiri Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model Gastroenterology Research and Practice |
| title | Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model |
| title_full | Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model |
| title_fullStr | Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model |
| title_full_unstemmed | Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model |
| title_short | Usefulness of 3-Dimensional Flexible Endoscopy in Esophageal Endoscopic Submucosal Dissection in an Ex Vivo Animal Model |
| title_sort | usefulness of 3 dimensional flexible endoscopy in esophageal endoscopic submucosal dissection in an ex vivo animal model |
| url | http://dx.doi.org/10.1155/2019/4051956 |
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