Mortagy M, Mehta N, Parsi MA, Abe S, Stevens T, Vargo JJ, Saito Y, Bhatt A. Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures. World J Gastroenterol 2017; 23(16): 2883-2890 [PMID: 28522906 DOI: 10.3748/wjg.v23.i16.2883]
Corresponding Author of This Article
Amit Bhatt, MD, Department of Gastroenterology and Hepatology, Digestive Disease Institute, A30, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States. bhatta3@ccf.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 28, 2017; 23(16): 2883-2890 Published online Apr 28, 2017. doi: 10.3748/wjg.v23.i16.2883
Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures
Mohamed Mortagy, Neal Mehta, Mansour A Parsi, Seiichiro Abe, Tyler Stevens, John J Vargo, Yutaka Saito, Amit Bhatt
Mohamed Mortagy, Department of Internal Medicine, Homer Stryker MD School of Medicine, Western Michigan University, Kalamazoo, MI 49008, United States
Neal Mehta, Department of Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Mansour A Parsi, Tyler Stevens, John J Vargo, Amit Bhatt, Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Seiichiro Abe, Yutaka Saito, Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Author contributions: All authors contributed equally to this work; all authors played a role in concept and design; acquisition of data; interpretation of data; drafting of the manuscript and critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: All authors have no conflicts-of-interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amit Bhatt, MD, Department of Gastroenterology and Hepatology, Digestive Disease Institute, A30, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States. bhatta3@ccf.org
Telephone: +1-216-4444880 Fax: +1-216-4446305
Received: January 18, 2017 Peer-review started: January 19, 2017 First decision: February 10, 2017 Revised: February 24, 2017 Accepted: March 15, 2017 Article in press: March 15, 2017 Published online: April 28, 2017 Processing time: 100 Days and 4.9 Hours
Abstract
Endoscopic submucosal dissection (ESD) is a well-established, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection (MAG-ESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon’s “second hand”. Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology.
Core tip: Magnetic anchor guided endoscopic submucosal dissection (MAG-ESD) is a promising technology that can offer tissue retraction independent of the endoscope which acts like an endoscopist’s “second hand”. The objective of this article is to present a scientific review of the technology, published work, limitations, and future potential of MAG-ESD.
