A Novel Approach to Endoscopic Colorectal Mucosal Resection Using a Three-Channel Outer Tube and Multiple Forceps: An Experimental Assessment

Background and Study Aims: Colorectal endoscopic mucosal resection (EMR) has limitations both anatomically and technically when it is done using the conventional snare wire method. The aim of this study was to develop a new method and instrument for colorectal EMR.

Methods: A total of 21 EMR procedures were done using ten surgical specimens. Saline was injected into the normal submucosa of freshly resected colorectal specimens to prepare a pseudotumor. EMR was performed experimentally by employing a three-channel outer tube with three forceps and a colonoscope with a needle-type precutting knife. This method was assessed in terms of safety and the size of the resected specimens.

Results: Perforation occurred only twice in the initial stage of this study. The size of the specimens resected by EMR was 28 - 39 mm (long diameter 34.8 ± 3.11), by 22 - 28 mm (short diameter 25.8 ± 2.07).

Conclusion: This method can achieve safety and en bloc mucosal resection to the submucosal layer. This novel approach may be promising for clinical application as a new form of endoscopic surgery.

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