| Theme | New developments in capsule/balloon-assisted endoscopy | |
|---|---|---|
| Title | Colorectal ESD using double-balloon endoscopy | |
| Publish Date | 2013/12 | |
| Author | Ai Fujimoto | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| Author | Toshio Uraoka | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| Author | Joichiro Horii | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| Author | Osamu Goto | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| Author | Yasutoshi Ochiai | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| Author | Koji Takahashi | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| Author | Naohisa Yahagi | Center for Research and Development of Minimally Invasive Treatment, Cancer Center, Keio University |
| [ Summary ] | Because of improvements in endoscopic devices which have led to reduced learning curves for endoscopists, colorectal ESD (endoscopic submucosal dissection) has become widely implemented in recent years. En-bloc resection using ESD procedures can result in more accurate histological assessment and subsequently make it possible to determine appropriate treatment strategies for additional treatment or follow ups. However, colorectal ESD has some disadvantages such as technical difficulties, longer operation times and higher complication rates compared to gastric ESD because of the poor maneuverability of colonoscopes caused by angulation and looping of the proximal or sigmoid colon. We usually performe colorectal ESD with a short DBE (double-balloon endoscope) system (EI-530B endoscope : Fujifilm Co, Tokyo, Japan) in such technically difficult cases. The total length of the shaft, and working channel of this endoscope are 182 cm, 152 cm, 9.4 mm, and 2.8 mm, respectively. The principle of DBE is that holding the colon wall with a balloon attached to the distal end of a soft overtube results in better maneuverability of colonoscopes. Some advantages of the use of DBE for colorectal ESD in cases of poor maneuverability with conventional colonoscopies are described. | |