Safety and efficacy of a novel powered endoscopic debridement tissue resection device for management of difficult colon and foregut lesions: first multicenter U.S. experience

Authors

Vivek Kaul, Department of Medicine, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, USA.
David Diehl, Department of Medicine, Division of Gastroenterology, Geisinger Health System, Danville, Pennsylvania, USA.
Sarah Enslin, Department of Medicine, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, USA.
Anthony Infantolino, Department of Medicine, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Christina Tofani, Department of Medicine, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Krystle Bittner, Department of Medicine, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, USA.
Raseen Tariq, Rochester Regional HealthFollow
Rida Aslam, Department of Medicine, Franciscan St James Hospital, Olympia Fields, Illinois, USA.
Kamran Ayub, Department of Medicine, Division of Gastroenterology, Silver Cross Medical Center, Oak Brook, Illinois, USA.

Department

Medicine

Document Type

Article

Publication Title

Gastrointestinal endoscopy

Abstract

BACKGROUND AND AIMS: The EndoRotor, nonthermal, powered endoscopic debridement (PED) instrument (Interscope Inc, Whitinsville, Mass, USA), is a novel device used in the GI tract. It uses adjustable suction and a rotary cutting blade to precisely resect mucosal and submucosal tissue. Our aim was to assess the technical feasibility, safety, and efficacy of PED using the EndoRotor device. METHODS: This was an Institutional Review Board-approved, multicenter, retrospective review. Patients underwent PED with the EndoRotor device from August 2018 to September 2019 at 4 high-volume U.S. centers. Patient demographics, indication for PED, and procedural and histopathologic data were recorded. RESULTS: Thirty-four patients underwent PED (41 lesions). The most common indications for PED were colon polyps (18, 52.9%) and Barrett's esophagus (8, 23.5%). Most lesions (35, 85.4%) were resected previously for the same indication using standard techniques. Technical success was achieved in 97.6% of lesions (n = 40). Clinical success was achieved in most patients who underwent a follow-up examination (19, 79.2%). Intraprocedural bleeding (in 10 patients) was managed endoscopically; no EndoRotor-related perforations occurred. Three postprocedural adverse events occurred: self-limited chest pain in 1 patient and delayed bleeding in 2. CONCLUSIONS: The EndoRotor is a novel, effective, and safe PED device for endoscopic resection of flat and polypoid lesions in the colon and foregut. It may have a promising role in the endoscopic management of naïve and scarred mucosal lesions based on this initial experience. Further prospective studies are needed to clarify its role in endoluminal resection.

First Page

640

Last Page

646

DOI

10.1016/j.gie.2020.06.068

Volume

93

Issue

3

Publication Date

7-6-2020

Recommended Citation

Kaul, V., Diehl, D., Enslin, S., Infantolino, A., Tofani, C., Bittner, K., Tariq, R., Aslam, R., & Ayub, K. (2020). Safety and efficacy of a novel powered endoscopic debridement tissue resection device for management of difficult colon and foregut lesions: first multicenter U.S. experience. Gastrointestinal endoscopy, 93 (3), 640-646. https://doi.org/10.1016/j.gie.2020.06.068