Gel immersion in endoscopy: Exploring potential applications

Table 2 Reports on gel immersion endoscopy for gastric lesions

Ref.	Year	Article type	Gel/jelly type	Pathophysiology	Indication for gel immersion	Delivery procedure	Outcome	Obstacles for gel immersion
Miura et al[16]	2018	Case report	OS-1 jelly	Gastric tumor (lesser curvature of the antrum)	ESD; difficult to identify bleeding point	-	Successfully achieved hemostasis with electrocautery forceps	Need to replace the gel with gas before applying electrocoagulation
Miura et al[36]	2022	Case report	OPF-203	Protruded tumor at the anterior wall of the pylorus	EMR; immediate flow of water made underwater EMR difficult	-	Successfully achieved en-bloc resection	-
Kimura et al[37]	2022	Case report	OPF-203	Gastric neoplasm (greater curvature of the upper gastric body)	ESD	-	Successfully achieved en-bloc resection	-
Michigami et al[38]	2023	Case report	OPF-203	Metastatic gastric tumor (clear cell renal cell carcinoma; greater curvature of the gastric body)	EMR	-	Successfully achieved en-bloc resection	-
Khurelbaatar et al[39]	2022	Case series	OPF-203	Two cases with gastric tumor	ESD; difficult to identify bleeding point	Forceps channel irrigator (manual injection)	Easy to detect the bleeding point and ensuring clear field of view in both cases	-
Muramatsu et al[40]	2023	Case report	OPF-203	Gastric cancer at the pylorus ring	ESD; Difficult to identify bleeding point and tunneling	-	Easy to detect the bleeding point and successfully widen the tunnel and achieved en-bloc resection	-
Suto et al[41]	2022	Case report	OPF-203	Gastric cancer at anterior wall of the pyloric ring	ESD; the tumor was prolapsed into the duodenal side and difficult to identify bleeding point	-	Prevent further prolapse. Detection of the bleeding point resulted in successfully achieved en-bloc resection	-
Orita et al[42]	2023	Case report	OPF-203	Gastric varices at fundus of the stomach	Cyanoacrylate injection; difficult to secure the endoscopic visual field due to the massive bleeding	Forceps channel irrigator (manual injection)	Continuous gel injection gradually improved the visual field. A total of 4 mL of cyanoacrylate was injected into the varices over five tries	A total of 500 mL of this gel was used

ESD: Endoscopic submucosal dissection; EMR: Endoscopic mucosal resection.