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World J Gastroenterol. Nov 21, 2008; 14(43): 6726-6732
Published online Nov 21, 2008. doi: 10.3748/wjg.14.6726
A novel device for endoscopic submucosal dissection, the Fork knife
Hyun Gun Kim, Joo Young Cho, Gene Hyun Bok, Won Young Cho, Wan Jung Kim, Su Jin Hong, Bong Min Ko, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim
Hyun Gun Kim, Joo Young Cho, Gene Hyun Bok, Won Young Cho, Wan Jung Kim, Su Jin Hong, Bong Min Ko, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim, Institute for Digestive Research, Digestive Disease Research Center, SoonChunHyang University College of Medicine, Seoul 140-743, South Korea
Author contributions: Kim HG and Cho JY contributed equally to this work; Kim HG, Cho JY designed research; Kim HG, Cho JY performed research; Kim HG, Cho JY, Bok GH, Cho WY and Kim WJ collected data; Kim HG, Cho JY analyzed data; Hong SJ, Ko BM, Kim JO, Lee JS, Lee MS, and Shim CS reviewed and corrected research design; Kim HG and Cho JY wrote the paper.
Correspondence to: Joo Young Cho, MD, PhD, Professor, Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, College of Medicine, SoonChunHyang University, 657 Hannam-Dong, Yongsan-Gu, Seoul 140-743, South Korea. cjy6695@dreamwiz.com
Telephone: +82-2-7099202 Fax: +82-2-7099696
Received: September 19, 2008
Revised: October 27, 2008
Accepted: November 4, 2008
Published online: November 21, 2008
Abstract

AIM: To introduce and evaluate the efficacy and technical aspects of endoscopic submucosal dissection (ESD) using a novel device, the Fork knife.

METHODS: From March 2004 to April 2008, ESD was performed on 265 gastric lesions using a Fork knife (Endo FS®) (group A) and on 72 gastric lesions using a Flexknife (group B) at a single tertiary referral center. We retrospectively compared the endoscopic characteristics of the tumors, pathological findings, and sizes of the resected specimens. We also compared the en bloc resection rate, complete resection rate, complications, and procedure time between the two groups.

RESULTS: The mean size of the resected specimens was 4.27 ± 1.26 cm in group A and 4.29 ± 1.48 cm in group B. The en bloc resection rate was 95.8% (254/265 lesions) in group A and 93.1% (67/72) in group B. Complete ESD without tumor cell invasion of the resected margin was obtained in 81.1% (215/265) of group A and in 73.6% (53/72) of group B. The perforation rate was 0.8% (2/265) in group A and 1.4% (1/72) in group B. The mean procedure time was 59.63 ± 56.12 min in group A and 76.65 ± 70.75 min in group B (P < 0.05).

CONCLUSION: The Fork knife (Endo FS®) is useful for clinical practice and has the advantage of reducing the procedure time.

Keywords: Fork knife, Novel device, Endoscopic submucosal dissection, Flexknife, Procedure time