Published online Jan 14, 2018. doi: 10.3748/wjg.v24.i2.211
Peer-review started: November 7, 2017
First decision: November 14, 2017
Revised: November 27, 2017
Accepted: December 5, 2017
Article in press: December 5, 2017
Published online: January 14, 2018
To evaluate appropriate and rapid polyglycolic acid sheet (PGAs) covering time using device delivery station system (DDSS).
This pilot basic study was conducted to evaluate the potential of accurate and rapid PGAs delivery using DDSS. Three 11-mo-old female Beagle dogs were used in this study. Two endoscopic submucosal dissections (ESDs) 4cm in diameter were performed in lesser curvature of middle gastric body and greater curvature of antrum (total 6 ESDs performed). DDSS (3 cm length, 12 mm in outer diameter) has 2 chambers which 16 cm2 large 2 PGAs were stored, and DDSS was attached post ESD ulcers, respectively. Beriplast P® (CSL Behring K.K., Tokyo, Japan) (combination of fibrin glue and thrombin) was applied equally to the artificial ulcer, and tight attachment of 2 PGAs with DDSS were completed. The evaluation items were covering times, post ESD bleeding and perforation during ESD.
The covering time of PGAs (defined as the duration from the beginning of endoscope insertion into the mouth to the end of the fibrin glue coating process) was 6.07 (4.86-8.29) min. There was no post-ESD bleeding (1-7 d after ESD), and there was no perforation during ESD.
DDSS was very useful for rapid delivering and tight attachment of PGAs, and has potentials of multi-purpose delivery station system.
Core tip: Although mechanical closures of larger artificial ulcer floor are effective to prevent post-endoscopic submucosal dissection (ESD) bleeding, mechanical closures might create a mucosal bridge which reduces the efficacy of prevention of post-ESD bleeding. Although covering with polyglycolic acid sheet (PGAs) is a more ideal treatment, it is difficult to deliver thin PGAs by pan-endoscope. Therefore, novel concept to deliver various devices and materials were developed.