Gel immersion in endoscopy: Exploring potential applications

Table 1 Reports on gel immersion endoscopy for esophageal lesions

Ref.	Year	Article type	Gel/jelly type	Pathophysiology	Indication for gel immersion	Delivery procedure	Outcome	Obstacles for gel immersion
Nakano et al[27]	2021	Case report	OPF-203	Esophageal cancer	ESD; discomfort and irritability due to CO2 insufflation	Disposable forceps cap (manual irrigator)	No CO2 insufflation was needed, and ESD was successfully completed/the bleeding speed slowed down	-
Nakano et all[28]	2022	Case series	OPF-203	Esophageal cancer	ESD; 14 patients who underwent ESD for middle and lower thoracic superficial esophageal cancer	Disposable forceps cap (manual irrigator)	Completed ESD with en bloc and R0 resections achieved in 100%; No delayed adverse events
Ishikawa et al[29]	2024	Case report	OPF-203	Esophageal cancer	ESD; significant fibrosis	-	Successfully completed ESD combined with underwater method and applying gel immersion	-
Iwatsubo et al[31]	2023	Case report	OPF-203	Esophageal cancer	ESD; difficult to secure visibility	ERCP catheter (as an additional irrigation tube)	Achieved curative resection	-
Kato et al[32]	2021	Retrospective analysis	Lubricating jelly	Esophageal varices	Esophageal varices imaging quality/esophageal varices detection	14-Fr catheter	Imaging quality was superior than water-filled method. Using jelly resulted in clearer depiction of perforated varices
Sekiguchi et al[33]	2022	Case report	OPF-203	Esophageal varices	Rupture of esophageal varices	Forceps channel	Easily identified bleeding point	Decrease in suction pressure due to the gel viscosity
Hasebe et al[34]	2022	Case report	OPF-203	Esophageal varices	Rupture of esophageal varices	Forceps channel	Easily identified bleeding point	Subsequent EVL failed- EIS was succeeded
Sugawara et al[35]	2023	Case report	OPF-203	Esophageal varices	EIS; non-rupture esophageal varices	Forceps channel		Accurately evaluate varices needs to EIS

EIS: Endoscopic injection sclerotherapy; EMR: Endoscopic mucosal resection; EUS: Endoscopic ultrasound; EVL: Endoscopic variceal ligation; ESD: Endoscopic submucosal dissection.