In a previous study, we proved that modified cap-assisted endoscopic mucosal resection (mEMR-C) is non-inferior to endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors smaller than 10 mm with a similar complete resection rate. In addition, mEMR-C had a shorter procedure duration time and lower hospitalization costs 1 . However, a snare needs to be precisely placed into the inner groove of the cap during the mEMR-C procedure, which is time-consuming and difficult for an inexperienced doctor. To solve this problem, we proposed a novel cap-assisted endoscopic resection device for resecting of a rectal lesion that might make the procedure much simpler and easier. In the current study, we initially explored the feasibility of this device for endoscopic resection in an in vitro pig model.
The cap-assisted endoscopic resection device comprises a transparent cap with a built-in metal snare and a cutting device with a metal hook ( Fig. 1 a, b, c ). Resection with the device was performed as follows ( Video 1 ). First, the cutting device with a metal hook was placed into the biopsy channel and then the metal snare was hooked by the metal hook. The transparent cap was then attached to the forward-viewing endoscope. After the endoscope was inserted into the in vitro pig rectum ( Fig. 1 d ), the rectal tissue was suctioned into the cap and gripped by tightening the snare. Finally, the rectal tissue was successfully resected ( Fig. 1 e ).
Fig. 1.
Cap-assisted endoscopic resection device for rectal lesion resection. a The schematic of the device. b The inside view of the transparent cap. c The metal hook of the cutting device. d The snare was hooked by the metal hook and the transparent cap was attached to the forward-viewing endoscope. e The rectal wound of the pig model after resection.
Video 1 An example of a cap-assisted endoscopic resection device for endoscopic resection in an in vitro pig rectal model.
In conclusion, this in vitro study demonstrated the feasibility of the cap-assisted endoscopic resection device for endoscopic resection of rectal lesions, which is a promising device for this purpose.
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Acknowledgement
This work was supported by Clinical Research Program of Nanfang Hospital, Southern Medical University (grant number 2021CR004) and the Science and Technology Planning Project of Guangdong Province (grant number 2017A020215139).
Footnotes
Competing interests The authors declare that they have no conflict of interest.
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Reference
- 1.Gao X, Huang S, Wang Y et al. Modified cap-assisted endoscopic mucosal resection versus endoscopic submucosal dissection for the treatment of rectal neuroendocrine tumors ≤10 mm: A randomized noninferiority trial. Am J Gastroenterol. 2022;117:1982–1989. doi: 10.14309/ajg.0000000000001914. [DOI] [PMC free article] [PubMed] [Google Scholar]