VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
Usefulness of gel immersion endoscopy for endoscopic resection in stomachs with residue.
СтатьяНазвание и аннотация: Перевод в очереди
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Hayashi Hiroki, Ino Yuji, Iwashita Chihiro, Sakaguchi Mio, Miura Yoshimasa, Despott Edward J, Yano Tomonori, Yamamoto Hironori
Аннотация
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.
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.