Subscribe to RSS

DOI: 10.1055/a-1145-3308
Dynamics of endoscopic snares: a new approach towards more practical and objective performance evaluation

Endoscopic resection using polypectomy snares is a standard method for treating gastrointestinal polyps. However, because few systems can objectively evaluate the capabilities of these snares, endoscopists tend to use them according to their personal preference. We developed a novel objective experimental system to evaluate the dynamic performance of these snares and evaluated their feasibility and reproducibility.
Using our system, we measured the sequential changes in hold-down and tightening force, which are essential capacities for all resection techniques using snares. To evaluate the system’s feasibility, the dynamic performances of three representative snares (product A: an oval-shaped standard snare, product B: a hexagonal-shaped standard snare, and product C: a rounded hard snare) were measured repeatedly.
Forces of each snare were measured to objectively show the dynamic changes in hold-down force during snaring. Results for each time point showed good reproducibility. The forces of product C were larger than those of products A and B, reflecting the subjective estimation on the market of the commercially available snares.
We developed a novel system for objectively measuring the dynamic performance of polypectomy snares. This system warrants further experiments.
Publication History
Received: 25 November 2019
Accepted: 02 March 2020
Article published online:
25 May 2020
© 2020. Owner and Copyright ©
© Georg Thieme Verlag KG
Stuttgart · New York
-
References
- 1 Winawer SJ, Zauber AG, Ho MN. et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 1993; 329: 1977-1981
- 2 Rex DK, Pohl H. Considering the impact of the flexible polypectomy snare. Endoscopy 2019; 51: 109-110
- 3 Ferlitsch M, Moss A, Hassan C. et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49: 270-297
- 4 Kawamura T, Takeuchi Y, Asai S. et al. A comparison of the resection rate for cold and hot snare polypectomy for 4–9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018; 67: 1950-1957
- 5 Yamashina T, Uedo N, Akasaka T. et al. Comparison of underwater vs conventional endoscopic mucosal resection of intermediate-size colorectal polyps. Gastroenterology 2019; 157: 451-461
- 6 Yamasaki Y, Uedo N, Takeuchi Y. et al. Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas. Endoscopy 2018; 50: 154-158
- 7 Shichijo S, Takeuchi Y, Kitamura M. et al. Does cold snare polypectomy completely resect the mucosal layer? A prospective single-center observational trial. J Gastroenterol Hepatol 2020; 35: 241-248
- 8 Yamano H, Matsushita H, Yamanaka K. et al. A study of physical efficacy of different snares for endoscopic mucosal resection. Digestive Endoscopy 2004; 16: S85-S88
- 9 Russell WMS, Burch RL. The principles of humane experimental technique. Wheathampstead (UK): Universities Federation for Animal Welfare; 1959
- 10 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310: 2191-2194