Efficacy of a new image-enhancement technique for achieving hemostasis in endoscopic submucosal dissection

Tadateru Maehata, Ai Fujimoto, Toshio Uraoka, Motohiko Kato, Joichiro Horii, Motoki Sasaki, Yoshiyuki Kiguchi, Teppei Akimoto, Atsushi Nakayama, Yasutoshi Ochiai, Osamu Goto, Toshihiro Nishizawa, Naohisa Yahagi

Research output: Contribution to journalArticle

Abstract

Background and Aims: Hemostasis during endoscopic submucosal dissection (ESD) can sometimes be challenging and stressful for the endoscopist. Therefore, we aimed to assess the usefulness of dual red imaging (DRI), a new image enhancement technique that uses 3 wavelengths (540, 600, and 630 nm) to visualize bleeding points and to examine the efficacy of DRI in shortening the time required to achieve hemostasis (hemostasis time) during ESD. Methods: DRI and white-light imaging (WLI) were used alternately for managing 378 bleeding events in 97 patients undergoing ESD. Hemostasis time for each hemostasis event was measured. Using portable eye-tracking glasses, 4 experienced endoscopists were shown random videos of intraoperative bleeding during ESD (20 cases each on WLI and DRI) and identified the bleeding point in each video. The mean distances of eye movement per unit of time until the bleeding point were identified in each video and compared between the WLI and DRI groups. Results: Average hemostasis time was significantly shorter in the DRI group. The mean distance of eye movement was significantly shorter in the DRI group than in the WLI group for all endoscopists. Conclusions: DRI can offer useful images to help in clearly detecting bleeding points and in facilitating hemostasis during ESD. It is feasible and may help in successfully performing ESD that is safer and faster than WLI. (Clinical trial registration number: UMIN000018309.)

Original languageEnglish
Pages (from-to)667-674
Number of pages8
JournalGastrointestinal Endoscopy
Volume92
Issue number3
DOIs
Publication statusPublished - 2020 Sep

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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  • Cite this

    Maehata, T., Fujimoto, A., Uraoka, T., Kato, M., Horii, J., Sasaki, M., Kiguchi, Y., Akimoto, T., Nakayama, A., Ochiai, Y., Goto, O., Nishizawa, T., & Yahagi, N. (2020). Efficacy of a new image-enhancement technique for achieving hemostasis in endoscopic submucosal dissection. Gastrointestinal Endoscopy, 92(3), 667-674. https://doi.org/10.1016/j.gie.2020.05.033