Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue
Background and Aims: EMR and endoscopic submucosal dissection are widely used for treating intramucosal gastric neoplasms. However, securing a clear visual field in a stomach with residue is challenging. In this article, we present 2 cases in which tumors were endoscopically resected by securing the...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | VideoGIE |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468448125000980 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849768427609128960 |
|---|---|
| author | Hiroki Hayashi, MD Yuji Ino, MD Chihiro Iwashita, MD, PhD Mio Sakaguchi, MD Yoshimasa Miura, MD, PhD Edward J. Despott, MD, FRCP, FEBGH, FASGE, FJGES, FESGE, MD (Res) Tomonori Yano, MD, PhD Hironori Yamamoto, MD, PhD |
| author_facet | Hiroki Hayashi, MD Yuji Ino, MD Chihiro Iwashita, MD, PhD Mio Sakaguchi, MD Yoshimasa Miura, MD, PhD Edward J. Despott, MD, FRCP, FEBGH, FASGE, FJGES, FESGE, MD (Res) Tomonori Yano, MD, PhD Hironori Yamamoto, MD, PhD |
| author_sort | Hiroki Hayashi, MD |
| collection | DOAJ |
| description | Background and Aims: EMR and endoscopic submucosal dissection are widely used for treating intramucosal gastric neoplasms. However, securing a clear visual field in a stomach with residue is challenging. In this article, we present 2 cases in which tumors were endoscopically resected by securing the visual field using the gel immersion method in remnant stomachs after proximal gastrectomy with residue. Methods: The gel immersion method is a technique in which a transparent, viscous gel is injected into the lumen to secure the visual field. The viscous gel displaces blood and residue, allowing for a clear view. Therefore, we could perform efficient endoscopic procedures calmly. We also used the dedicated valve to add the gel while we inserted devices through its accessory channel. Results: In both cases, the gel immersion method successfully displaced food residue, providing a clear visual field and enabling precise mucosal incision and resection. In the first case, we achieved en bloc resection in a 71-year-old man with a 5-mm adenoma by using gel immersion EMR. In the second case, a 74-year-old man with a 12-mm intramucosal adenocarcinoma underwent gel immersion endoscopic submucosal dissection, which facilitated an accurate incision line and effective coagulation. Both patients had negative resection margins, and no adverse events were observed. Conclusions: The gel immersion method effectively improved visualization in a stomach with residue, enhancing the safety and precision of endoscopic resection. |
| format | Article |
| id | doaj-art-baadaf57473c4868b3279eb4cb1a2a3c |
| institution | DOAJ |
| issn | 2468-4481 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | VideoGIE |
| spelling | doaj-art-baadaf57473c4868b3279eb4cb1a2a3c2025-08-20T03:03:49ZengElsevierVideoGIE2468-44812025-09-0110946947410.1016/j.vgie.2025.03.040Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residueHiroki Hayashi, MD0Yuji Ino, MD1Chihiro Iwashita, MD, PhD2Mio Sakaguchi, MD3Yoshimasa Miura, MD, PhD4Edward J. Despott, MD, FRCP, FEBGH, FASGE, FJGES, FESGE, MD (Res)5Tomonori Yano, MD, PhD6Hironori Yamamoto, MD, PhD7Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, JapanDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, JapanDepartment of Gastroenterology and Hepatology, Mie University, Mie, JapanDepartment of Diagnostic Pathology, Jichi Medical University, Tochigi, JapanDivision of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, JapanRoyal Free Unit for Endoscopy, The Royal Free Hospital and UCL Institute for Liver and Digestive Health, London, United KingdomDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan; Corresponding author: Tomonori Yano, MD, PhD, Department of Medicine, Division of Gastroenterology, Jichi Medical, University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.Department of Endoscopic Research and International Education funded by FUJIFILM Medical Co, Ltd, Jichi Medical University, Tochigi, JapanBackground and Aims: EMR and endoscopic submucosal dissection are widely used for treating intramucosal gastric neoplasms. However, securing a clear visual field in a stomach with residue is challenging. In this article, we present 2 cases in which tumors were endoscopically resected by securing the visual field using the gel immersion method in remnant stomachs after proximal gastrectomy with residue. Methods: The gel immersion method is a technique in which a transparent, viscous gel is injected into the lumen to secure the visual field. The viscous gel displaces blood and residue, allowing for a clear view. Therefore, we could perform efficient endoscopic procedures calmly. We also used the dedicated valve to add the gel while we inserted devices through its accessory channel. Results: In both cases, the gel immersion method successfully displaced food residue, providing a clear visual field and enabling precise mucosal incision and resection. In the first case, we achieved en bloc resection in a 71-year-old man with a 5-mm adenoma by using gel immersion EMR. In the second case, a 74-year-old man with a 12-mm intramucosal adenocarcinoma underwent gel immersion endoscopic submucosal dissection, which facilitated an accurate incision line and effective coagulation. Both patients had negative resection margins, and no adverse events were observed. Conclusions: The gel immersion method effectively improved visualization in a stomach with residue, enhancing the safety and precision of endoscopic resection.http://www.sciencedirect.com/science/article/pii/S2468448125000980 |
| spellingShingle | Hiroki Hayashi, MD Yuji Ino, MD Chihiro Iwashita, MD, PhD Mio Sakaguchi, MD Yoshimasa Miura, MD, PhD Edward J. Despott, MD, FRCP, FEBGH, FASGE, FJGES, FESGE, MD (Res) Tomonori Yano, MD, PhD Hironori Yamamoto, MD, PhD Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue VideoGIE |
| title | Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue |
| title_full | Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue |
| title_fullStr | Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue |
| title_full_unstemmed | Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue |
| title_short | Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue |
| title_sort | usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue |
| url | http://www.sciencedirect.com/science/article/pii/S2468448125000980 |
| work_keys_str_mv | AT hirokihayashimd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT yujiinomd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT chihiroiwashitamdphd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT miosakaguchimd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT yoshimasamiuramdphd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT edwardjdespottmdfrcpfebghfasgefjgesfesgemdres usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT tomonoriyanomdphd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue AT hironoriyamamotomdphd usefulnessofgelimmersionendoscopyforendoscopicresectioninstomachswithresidue |