Usefulness of a novel slim type FlushKnife-BT over conventional FlushKnife-BT in esophageal endoscopic submucosal dissection

Figure 1 Ball-tipped FlushKnife and a novel slim type ball-tipped FlushKnife. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT.

Figure 2 Water aspiration speed. A total of 200 mL water in a graduated cylinder was aspirated by scopes with 2.8-mm and 3.2-mm channels with FlushKnife-BT or FlushKnife-BTS inserted, and the amount of aspirated water in 10 s was measured. The column denotes mean data and the bar shows the range of experiments performed 9 times. Water aspiration speed was markedly faster with FlushKnife-BTS than with FlushKnife-BT. ^aP < 0.05, BT vs BTS. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT.

Figure 3 Resistance to knife insertion inside the scope. Resistance to the insertion of Flushknife-BT or Flushknife-BTS inside the scope at various endoscopic angles was measured using a measuring instrument by NIDEC-SHIMPO CORPORATION. The column denotes mean data and the bar shows the range of experiments performed in triplicate. Resistance was lower at all endoscopic angles with Flushknife-BTS than with Flushknife-BT. ^aP < 0.05, BT vs BTS. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT.

Figure 4 Waterjet flushing speed. Waterjet flushing speed was faster with FlushKnife-BT than with FlushKnife-BTS at all pump settings tested. ^aP < 0.05, BT vs BTS. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT.

Figure 5 Flow diagram of cases that underwent endoscopic submucosal dissection included in the analysis. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT; ESD: Endoscopic submucosal dissection.

Figure 6 Treatment speed was faster with a novel slim type ball-tipped FlushKnife when the resected size was large, but was similar to that with the conventional knife when the resected size was small. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT.

Figure 7 Frequency of knife replacement was reduced with a novel slim type ball-tipped FlushKnife regardless of the resected size, while a slightly reduced frequency was observed as the resected size became larger. FlushKnife-BT: Ball-tipped FlushKnife; FlushKnife-BTS: A novel slim type FlushKnife-BT.