Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue

Q3 Medicine

VideoGIE Pub Date : 2025-04-09 DOI:10.1016/j.vgie.2025.03.040

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

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引用次数: 0

Abstract

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.

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凝胶浸泡内镜在残胃内镜切除中的应用

背景和目的：内镜下粘膜下解剖术和内镜下粘膜下解剖术被广泛应用于胃粘膜内肿瘤的治疗。然而，在有残留物的胃中确保清晰的视野是具有挑战性的。本文报告2例近端残胃切除术后残胃用凝胶浸泡法固定视野的内镜下肿瘤切除术。方法凝胶浸泡法是一种将透明的粘性凝胶注入腔内以保护视野的技术。粘稠的凝胶取代了血液和残留物，使视野清晰。因此，我们可以冷静地进行有效的内窥镜手术。当我们通过其附属通道插入设备时，我们也使用专用阀门添加凝胶。结果凝胶浸泡法均成功清除了食物残渣，视野清晰，能实现精确的粘膜切开切除。在第一个病例中，我们通过凝胶浸泡EMR对一名71岁男性5毫米腺瘤进行了整体切除。在第二个病例中，74岁的男性患者患有12mm的粘膜内腺癌，在内镜下进行了凝胶浸泡粘膜下剥离，这有助于准确的切口线和有效的凝血。两例患者切除边缘均为阴性，未观察到不良事件。结论凝胶浸泡法有效改善了残留胃的可视化，提高了内镜切除的安全性和准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.