Magnetic anchors with line-guided endoscopic full-thickness resection for gastric submucosal tumors.

Abstract

The advantage of endoscopic submucosal dissection (ESD) is the ability to achieve high R0 resection and a low local recurrence rate (Oyama in Gastrointest Endosc Clin N Am 24:201-212, 2014;Cai et al. in Gastrointest Endosc 88:160-167, 2018;). Endoscopic full-thickness resection (EFTR) compensates for the deficiency of ESD, and it can treat more ailments (Aslanian et al. in VideoGIE 4:343-350, 2019). However, due to the requirements of EFTR for endoscopic resection experience and defect closure skills, the operation is relatively difficult, which is the greatest obstacle to the widespread clinical use of EFTR (Chu and Xu in Am J Gastroenterol 115:1972-1973, 2020). Here, we propose a useful method-a magnetic anchor with line guidance (MALG-EFTR). In addition, the device provides satisfactory tissue tension within the submucosa, facilitates visualization of the dissection plane, strengthens counter traction, and reduces the difficulty of surgery during EFTR. MALG-EFTR can effectively prevent the magnetic anchor from falling off or remaining in the abdominal cavity or digestive tract, which facilitates the recovery of specimens. Therefore, this technique might reduce procedure time and increase the stabilization and safety of operations.