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Magnetic anchor-guided endoscopic submucosal dissection for colorectal tumors (with video)

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Abstract

Background

The feasibility of magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD) using a neodymium magnet for colorectal tumors has not been evaluated. The aim of this study was to clarify the feasibility of MAG-ESD for colorectal tumors.

Methods

This prospective trial was conducted at Yamashita Hospital. MAG-ESD was performed for 49 colorectal tumors. The magnetic anchor comprised an internal magnet attached to an endoclip with 3-0 silk. Both external and internal magnets were made using neodymium magnets. The feasibility of traction achieved using MAG-ESD, en bloc resection rate, complete en bloc resection rate, time required for preparation and attachment of the magnetic anchor, procedure time, rate of retrieval of magnetic anchors, and adverse events were evaluated.

Results

MAG-ESDs were successfully performed for 48 colorectal tumors except for a rectal case in which the internal magnet stuck to the endoscope. En bloc resections and complete en bloc resections were achieved in all cases. Attaching the magnetic anchor required a median of 8 min (range 3–37 min). Median procedure time was 76 min (range 28–283 min) and the magnetic anchors were retrieved in all cases without adverse events.

Conclusion

MAG-ESD is feasible and safe in the colon and may facilitate the treatment of all difficult lesions. (UMIN000024100).

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Acknowledgements

We thank endoscopic technician, Natsuki Sako for her assistance during the conduct of the study.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Yamashita Hospital, 1-3-5 Nakamachi, Ichinomiya, Aichi, 491-8531, Japan

    Ippei Matsuzaki, Masashi Hattori, Hiroki Yamauchi, Naoya Goto & Yuji Iwata

  2. Department of Pathology, Yamashita Hospital, Ichinomiya, Japan

    Takio Yokoi

  3. Department of Nursing, Yamashita Hospital, Ichinomiya, Japan

    Mafu Tsunemi

  4. Department of Gastroenterology, Yokkaichi Municipal Hospital, Yokkaichi, Japan

    Makoto Kobayashi

  5. Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan

    Takeshi Yamamura

  6. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Ryoji Miyahara

Authors
  1. Ippei Matsuzaki
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  2. Masashi Hattori
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Corresponding author

Correspondence to Masashi Hattori.

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Disclosures

Drs. Ippei Matsuzaki, Masashi Hattori, Hiroki Yamauchi, Naya Goto, Yuji Iwata, Takio Yokoi, Mafu Tsunemi, Makoto Kobayashi, Takeshi Yamamura and Ryoji Miyahara have no conflicts of interest or financial ties to disclose.

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Video 1: Demonstration of the magnetic anchor-guided ESD procedure in the cecum.Supplementary material 1 (MP4 279722 kb)

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Matsuzaki, I., Hattori, M., Yamauchi, H. et al. Magnetic anchor-guided endoscopic submucosal dissection for colorectal tumors (with video). Surg Endosc 34, 1012–1018 (2020). https://doi.org/10.1007/s00464-019-07127-9

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  • DOI: https://doi.org/10.1007/s00464-019-07127-9

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