Basic Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2019; 25(28): 3764-3774
Published online Jul 28, 2019. doi: 10.3748/wjg.v25.i28.3764
Novel technique for endoscopic en bloc resection (EMR+) - Evaluation in a porcine model
Benjamin Meier, Andreas Wannhoff, Christoph Klinger, Karel Caca
Benjamin Meier, Andreas Wannhoff, Christoph Klinger, Karel Caca, Department of Gastroenterology, Klinikum Ludwigsburg, Ludwigsburg 71640, Germany
Author contributions: Meier B and Caca K have performed the ex vivo and in vivo experiments; Meier B has analyzed the data; Meier B, Andreas W and Christoph K have prepared the manuscript; and Caca K has approved the final version.
Institutional review board statement: Study was approved by local authority.
Institutional animal care and use committee statement: This study was approved by Regierungspräsidium Baden-Württemberg, Germany (approval number C1/15).
Conflict-of-interest statement: Karel Caca has received lecture fees for FTRD-training courses. Benjamin Meier, Andreas Wannhoff and Christoph Klinger have nothing to disclose.
Data sharing statement: No additional unpublished data are available.
ARRIVE guidelines statement: The ARRIVE guidelines have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Benjamin Meier, MD, Adjunct Professor, Doctor, Klinikum Ludwigsburg, Department of Gastroenterology, Posilipostraße 4, Ludwigsburg 71640, Germany.
Telephone: +49-7141-9967201 Fax: +49-7141-9967219
Received: March 4, 2019
Peer-review started: March 4, 2019
First decision: April 8, 2019
Revised: May 24, 2019
Accepted: June 7, 2019
Article in press: June 8, 2019
Published online: July 28, 2019
Core Tip

Core tip: We report on a novel modified grasp and snare technique (EMR+) forendoscopic en bloc resection. The technique was developed ex vivo (explanted pig stomach) and evaluated in vivo in a porcine model (stomach, 3 domestic pigs). EMR+ includes a novel additional working channel (AWC®) and a new agent (consisting of poloxamers) for submucosal injection (LiftUp®, approval expected in early 2019). EMR+ appeared to be effective and safe in the stomach and allowed for en bloc resection for lesions up to 40 mm. EMR+ needs to be further evaluated clinically in comparative trials.