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CC BY 4.0 · Endoscopy 2024; 56(S 01): E70-E71
DOI: 10.1055/a-2222-6958
E-Videos

Novel traction device for endoscopic submucosal dissection: a rotatable transparent cap, an additional channel, and a traction wire

Xi Chen  ‡
1   Gastroenterology, Zhangzhou Traditional Chinese Medicine Hospital, Zhangzhou, China
2   Gastroenterology, Fujian University of Traditional Chinese Medicine, Fuzhou, China (Ringgold ID: RIN47858)
,
Zhenqun Lin‡
1   Gastroenterology, Zhangzhou Traditional Chinese Medicine Hospital, Zhangzhou, China
2   Gastroenterology, Fujian University of Traditional Chinese Medicine, Fuzhou, China (Ringgold ID: RIN47858)
,
Xiangqing Li
3   Intelligent Biomedical Robot Lab, College of Artificial Intelligence and Big Data for Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
,
Xiaoning Yang
4   Gastroenterology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
5   Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
,
Wenjuan Liu
6   Fujian University of Traditional Chinese Medicine, Fuzhou, China (Ringgold ID: RIN47858)
7   Endocrinology, Zhangzhou Traditional Chinese Medicine Hospital, Zhangzhou, China
,
Zehui Huang
2   Gastroenterology, Fujian University of Traditional Chinese Medicine, Fuzhou, China (Ringgold ID: RIN47858)
8   Zhangzhou Traditional Chinese Medicine Hospital, Zhangzhou, China
,
Shuntian Cai
4   Gastroenterology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
9   Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Zhongshan Hospital of Xiamen University, Xiamen, China
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Traditionally, endoscopic procedures have been limited to a single–channel device, making it difficult for endoscopists to perform endoscopic submucosal dissection (ESD). As a result, several solutions have been developed, each with its own advantages and disadvantages, including traction devices [1] [2], double-channel endoscopes [3], laparoscopy–endoscopy combined surgery [4], and surgical endoscopic robots [5]. To address these challenges, we fabricated a rotatable transparent cap with a fixed channel that can accommodate endoscopic surgical instruments.

The traction device consists of three components: a rotatable transparent cap, an additional channel, and a traction wire ([Fig. 1]). The additional channel and traction wire are connected to a rotatable ring on the transparent cap. By pulling the traction wire, the additional channel can be rotated around the transparent cap ([Fig. 1]).

Zoom Image
Fig. 1 Structure and functionality of the rotatable transparent cap device (Micro-Tech, Nanjing, China). a The rotatable transparent cap unit consists of a transparent cap with a rotatable ring in the middle section. A nylon wire threaded through a channel in the rotatable ring is fixed at its midpoint to the ring. b Auxiliary channel fixed to the rotatable ring. c Ends of the nylon wire that is connected to the ring and additional channel. Both ends of the wire can be used to pull the ring, rotating it. d The wire can be pulled to rotate the auxiliary channel on the ring around the transparent cap, enabling precise control.

During ESD, foreign-body forceps are inserted into the additional channel to clamp and push the tumor to the distal end, acting as a traction device. During the operation, the position of the additional channel can be controlled dynamically by pulling the traction wire. To assess the efficacy of this device, we performed ESD in four directions: downward, upward, leftward, and rightward. The results demonstrated that this rotatable transparent cap device enables dynamic rotation of the foreign-body forceps in various directions to apply traction ([Video 1]). This not only decreases the complexity of the procedure and the associated risks, but also leads to a significant reduction in operation time and incidence of complications.


Quality:
Structural features, functionality, and application of the novel traction device for endoscopic submucosal dissection (ESD) using an isolated pig stomach.Video 1

In conclusion, this device exhibits promise for facilitating traction during ESD, simplifying the procedure and eliminating the need for specialized endoscopic equipment.

Endoscopy_UCTN_Code_TTT_1AQ_2AD

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Publication History

Article published online:
23 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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