Skip to main content

Advertisement

SpringerLink
Log in

Bipolar-current needle-knife with a water jet function (Jet B-knife) shortens the procedure time of endoscopic submucosal dissection for colorectal tumors

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Endoscopic submucosal dissection (ESD) is a technically difficult and time-consuming procedure for the treatment of large colorectal tumors. In Japan, the ball-tip bipolar-current needle-knife (BB-knife) has been used in ESD as a safe device that minimizes the damage to deeper tissues of colorectal neoplasms. In May 2012, a BB-knife combined with a water jet function (Jet B-knife) was newly developed.

Methods

This retrospective study was aimed at examining the effectiveness and safety of the Jet B-knife. The BB-knife was used in 276 lesions (BB-knife group), while the Jet B-knife was used in 245 lesions (Jet B-knife group). We evaluated tumor characteristics and the results of the ESD procedures, including the size of the resected tumor, histological diagnosis, time required for resection, frequency of using other electrical devices, en bloc resection rate, and incidence rate of associated complications. Then, the data obtained were compared between the two groups.

Results

The histological evaluation of the resected tumors revealed that the incidence of cancer was not significantly different between the two groups. The median time required for resection was 103 min (45–255) in the BB-knife group and 51 min (28–210) in the Jet B-knife group. The difference was statistically significant (p < 0.05). Furthermore, the median tumor diameters were 23.1 mm (18–50) and 26.2 mm (20–60) in the BB-knife and Jet B-knife groups, respectively, demonstrating a statistically significant difference (p < 0.05). Multivariate logistic regression analysis revealed that short resection time (p < 0.001) and reduced use of hemostatic devices (p < 0.01) were independent favorable features of Jet B-knife. The en bloc resection rate and the perforation rate were not statistically significant between the two groups.

Conclusions

Use of the Jet B-knife may contribute to the development of a time-saving, cost-effective, and safe procedure for ESD of colorectal tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Tanaka M, Ono H, Hasuike N et al (2008) Endoscopic submucosal dissection of early gastric cancer. Digestion 77(Suppl 1):23–28

    Article  Google Scholar 

  2. Oyama T, Tomori A, Hotta K et al (2005) Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 3(Suppl 1):67–70

    Article  Google Scholar 

  3. Saito Y, Uraoka T, Yamaguchi Y et al (2010) A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 72:1217–1225

    Article  Google Scholar 

  4. Tanaka S, Kashida H, Saito Y et al (2015) JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 27:417–434

    Article  Google Scholar 

  5. Fujishiro M, Yahagi N, Kakushima N et al (2007) Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases. Clin Gastroenterol Hepatol 5:678–683

    Article  Google Scholar 

  6. Honma K, Kobayashi M, Watanabe H et al (2010) Endoscopic submucosal dissection for colorectal neoplasia. Dig Endosc 22:307–311

    Article  Google Scholar 

  7. Hurlstone DP, Atkinson R, Sanders DS et al (2007) Achieving R0 resection in the colorectum using endoscopic submucosal dissection. Br J Surg 94:1536–1542

    Article  CAS  Google Scholar 

  8. Iizuka H, Okamura S, Onozato Y et al (2009) Endoscopic submucosal dissection for colorectal tumors. Gastroenterol Clin Biol 33:1004–1011

    Article  CAS  Google Scholar 

  9. Isomoto H, Nishiyama H, Yamaguchi N et al (2009) Clinicopathological factors associated with clinical outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy 41:679–683

    Article  CAS  Google Scholar 

  10. Matsumoto A, Tanaka S, Oba S et al (2010) Outcome of endoscopic submucosal dissection for colorectal tumors accompanied by fibrosis. Scand J Gastroenterol 45:1329–1337

    Article  Google Scholar 

  11. Nishiyama H, Isomoto H, Yamaguchi N et al (2010) Endoscopic submucosal dissection for laterally spreading tumours of the colorectum in 200 consecutive cases. Surg Endosc 24:2881–2887

    Article  Google Scholar 

  12. Fusaroli P, Grillo A, Zanarini S et al (2009) Usefulness of a second endoscopic arm to improve therapeutic endoscopy in the lower gastrointestinal tract. Preliminary experience—a case series. Endoscopy 41:997–1000

    Article  CAS  Google Scholar 

  13. Uraoka T, Kato J, Ishikawa S et al (2007) Thin endoscope-assisted endoscopic submucosal dissection for large colorectal tumors (with videos). Gastrointest Endosc 66:836–839

    Article  Google Scholar 

  14. Ishii N, Itoh T, Horiki N et al (2010) Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife for large superficial colorectal neoplasias including ileocecal lesions. Surg Endosc 24:1941–1947

    Article  Google Scholar 

  15. Kanamori A, Nakano M, Kondo M et al (2017) Clinical effectiveness of the pocket-creation method for colorectal endoscopic submucosal dissection. Endosc Int Open 5:E1299–E1305

    Article  Google Scholar 

  16. Yoshii S, Akasaka T, Hayashi Y et al (2018) “Underwater” endoscopic submucosal dissection: a novel method for resection in saline with a bipolar needle knife for colorectal epithelial neoplasia. Surg Endosc 32:5031–5036

    Article  Google Scholar 

  17. Tanaka S, Toyonaga T, East J et al (2010) Endoscopic retrieval method using a small grip-seal plastic bag for large colorectal resection specimens after endoscopic submucosal dissection. Endoscopy 42(Suppl 2):E186–187

    Article  Google Scholar 

  18. Toyonaga T, Man-i M, Chinzei R et al (2010) Endoscopic treatment for early stage colorectal tumors: the comparison between EMR with small incision, simplified ESD, and ESD using the standard flush knife and the ball tipped flush knife. Acta Chir Iugosl 57:41–46

    Article  CAS  Google Scholar 

  19. Harada A, Gotoda T, Fukuzawa M et al (2013) Clinical impact of endoscopic devices for colorectal endoscopic submucosal dissection. Digestion 88:72–78

    Article  Google Scholar 

  20. Suzuki T, Hara T, Kitagawa Y et al (2016) Usefulness of IT knife nano for endoscopic submucosal dissection of large colo-rectal lesions. Acta Gastroenterol Belg 79:186–190

    CAS  PubMed  Google Scholar 

  21. Oka S, Tanaka S, Takata S et al (2012) Usefulness and safety of SB knife Jr in endoscopic submucosal dissection for colorectal tumors. Dig Endosc 24(Suppl 1):90–95

    Article  Google Scholar 

  22. Sano Y, Fu KI, Saito Y et al (2006) A newly developed bipolar-current needle-knife for endoscopic submucosal dissection of large colorectal tumors. Endoscopy 38(Suppl 2):E95

    Article  Google Scholar 

  23. Takeuchi Y, Uedo N, Ishihara R et al (2010) Efficacy of an endo-knife with a water-jet function (Flushknife) for endoscopic submucosal dissection of superficial colorectal neoplasms. Am J Gastroenterol 105:314–322

    Article  Google Scholar 

  24. Hotta K, Oyama T, Shinohara T et al (2010) Learning curve for endoscopic submucosal dissection of large colorectal tumors. Dig Endosc 22:302–306

    Article  Google Scholar 

  25. Jeon HH, Lee HS, Youn YH et al (2016) Learning curve analysis of colorectal endoscopic submucosal dissection (ESD) for laterally spreading tumors by endoscopists experienced in gastric ESD. Surg Endosc 30:2422–2430

    Article  Google Scholar 

  26. Watanabe T, Itabashi M, Shimada Y et al (2015) Japanese Society for Cancer of the Colon and Rectum. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol 20:207–239

    Article  Google Scholar 

  27. Schlemper RJ, Riddell RH, Kato Y et al (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47:251–255

    Article  CAS  Google Scholar 

  28. Mori H, Kobara H, Nishiyama N et al (2017) Novel effective and repeatedly available ring-thread counter traction for safer colorectal endoscopic submucosal dissection. Surg Endosc 31:3040–3047

    Article  Google Scholar 

  29. Yamasaki Y, Takeuchi Y, Uedo N et al (2017) Efficacy of traction-assisted colorectal endoscopic submucosal dissection using a clip-and-thread technique: a prospective randomized study. Dig Endosc 30:467–476

    Article  Google Scholar 

  30. Sakamoto N, Osada T, Shibuya T et al (2009) Endoscopic submucosal dissection of large colorectal tumors by using a novel spring-action S–O clip for traction (with video). Gastrointest Endosc 69:1370–1374

    Article  Google Scholar 

  31. Ritsuno H, Sakamoto N, Osada T et al (2014) Prospective clinical trial of traction device-assisted endoscopic submucosal dissection of large superficial colorectal tumors using the S–O clip. Surg Endosc 28:3143–3149

    Article  Google Scholar 

  32. Shiga H, Endo K, Kuroha M et al (2014) Endoscopic submucosal dissection for colorectal neoplasia during the clinical learning curve. Surg Endosc 28:2120–2128

    Article  Google Scholar 

  33. Sakamoto T, Saito Y, Fukunaga S et al (2011) Learning curve associated with colorectal endoscopic submucosal dissection for endoscopists experienced in gastric endoscopic submucosal dissection. Dis Colon Rectum 54:1307–1312

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Dr. Yatsugi Noda, Director of Saiseikai Takaoka Hospital, for his support in this study. This research was partially supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C) Grant Number JP 19K08464 and Japan Agency for Medical Research and development, AMED.under Grant Number JP19fk0310116, JP19fk0210047, and JP19fk0210058.

Author information

Authors and Affiliations

  1. Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan

    Katsushi Hiramatsu, Tatsushi Naito, Yu Akazawa, Yasushi Saito, Takuto Nosaka, Kazuto Takahashi, Kazuya Ofuji, Hidetaka Matsuda, Masahiro Ohtani & Yasunari Nakamoto

  2. Toyama Prefectural Central Hospital, Toyama, Japan

    Mitsuru Matsuda & Akito Sakai

Authors
  1. Katsushi Hiramatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tatsushi Naito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu Akazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasushi Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takuto Nosaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuto Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kazuya Ofuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hidetaka Matsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Masahiro Ohtani
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mitsuru Matsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Akito Sakai
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yasunari Nakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasunari Nakamoto.

Ethics declarations

Disclosures

All authors, namely Hiramatsu K, Naito T, Akazawa Y, Saito Y, Nosaka T, Takahashi K, Ofuji K, Matsuda H, Ohtani M, Matsuda, Sakai A, and Nakamoto Y, have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hiramatsu, K., Naito, T., Akazawa, Y. et al. Bipolar-current needle-knife with a water jet function (Jet B-knife) shortens the procedure time of endoscopic submucosal dissection for colorectal tumors. Surg Endosc 35, 3600–3606 (2021). https://doi.org/10.1007/s00464-020-07832-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-07832-w

Keywords

Search

Navigation