Endoscopic treatment of scarred polyps with a non-thermal device (Endorotor): A review of the literature‎

Table 1 Available published evidence for the EndoRotor endoscopic powered resection system

‎Ref.	Type	Resected lesions	Comments/reported complications
Hollerbach et al[14], 2016	In vivo animal study	Gastric (15 lesions; 4 oesophagus, 9 stomach and 2 duodenum) and colonic (10 lesions)	Minimal bleeding (blood loss did not exceed more than 10 – 15 cc of blood); No perforations occurred during “normal” resections. EndoRotor® was significantly faster than current standard techniques, 2 perforations occurred (these serious adverse events only occurred during experiments that were performed deliberately to test the limits of the gastrointestinal wall when excessive force was applied)
Tillinger et al[15], 2016	Case report	Circumferential rectal recurrent scarred LST-G mixed lesion 3 cm in length	The whole lesion could be removed in two sessions. Minor bleeding was controlled by means of adrenalin-injection and coagulation with argon plasma. No further complications occurred
Surkunalingam et al[16], 2018	Case report	20 m, Paris IIa+c	Prolonged time; The inability to obtain an en-bloc specimen
Emmanuel et al[20], 2021	Retrospective study	41 lesions post EMR or pEMR. Anorectum/rectum 8 (19.5), left-sided colon segment 10 (24.4), right-sided colon segment 13 (31.7) Caecum 10 (24.4)	Only one case of postpolypectomy syndrome 1 (2.4)
Kandiah et al[19], 2019	Prospective pilot study	19 flat scared polyps (Paris 0-IIa/0-IIb/0-Is) from 7 to 70 mm in the rectum and sigmoid	Cured maximally in 2 sessions. Minor intraprocedural bleeding in 2 cases. There were no perforations, delayed bleeding, postpolypectomy syndrome or complications requiring surgery
Stadler et al[17], 2019	Case report	Recurrent rectal adenoma LST-G	No reported complication successful removal of the scarred part in combination with ESD
Pellegatta et al[18], 2020	Case report	Scarred polyp in the rectum, a LST-G of 40 mm, hemicirconferential with adenomatous pit pattern (Kudo IIIL)	No recurrence was endoscopically revealed at 6 months’ follow-up. Complete removal in one session
Kaul et al[21], 2021	Retrospective study	41 lesions; Oesophagus 8 (23.5); Duodenum 5 (14.7); Colon18 (52.9); Rectum 3 (8.8)	Technical success (the ability to complete PED using the EndoRotor device without the use of additional resection modalities) was achieved in 97.6% of lesions (n = 40). Clinical success (no endoscopic and/or histologic evidence of residual/recurrent lesion on follow-up examination) was achieved in 79.2% of patients. Adverse events were reported in 3 patients (8.8%). postprocedural chest pain in one patient with oesophageal lesion. Two patients had delayed bleeding with colonic lesions. Intraprocedural bleeding was observed in 10 patients (29.4%; 4 colon, 5 oesophageal, and 1 duodenum)

LST-G: Laterally spreading granular tumour; EMR: Endoscopic mucosal resection; pEMR: Piecemeal endoscopic mucosal resection; PED: Powered endoscopic debridement.