ATH-06 First clinical experience with speedboat Rs2, a new multimodality device for colonic submucosal dissection. (June 2019)

• Record Type: Journal Article
• Authors: Tsiamoulos, Zacharias P; Stasinos, Ioannis; Oikonomakis, Aristeidis; Sebastian, Joseph; Bagla, Nipin; Hancock, Christopher; Saunders, Brian P
• Is Part Of: Gut. Volume 68(2019)Supplement 2
• Page Start: A7
• Page End: A8
• Publication Date: 2019-06
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-BSGAbstracts.13
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: The 'Speedboat-RS2' (Creo-Medical/Wales/UK) is the first multi-modality device, incorporating bipolar-radiofrequency energy for cutting, microwave energy for coagulation, an integrated needle for submucosal injection, and a rotatable blade with a heat insulated hull. Methods: A prospective database from June 2018 to Jan 2019 was analyzed including 20 consecutive patients (mean age: 69.7±15.18 years, 50% males) with 20 colorectal Lateral Spreading Tumours/LSTs. Two operators performed all colonic endoscopic submucosal dissections/ESDs. Results: Sixteen procedures were performed under conscious sedation and 4 general anaesthesia (Olympus/CF-HQ290ZL/13.2 mm tip diameter). Median lesion size was 4 cm (range 1–9 cm). The LSTs and procedural characteristics are described in table 1 . 1/20 case was abandoned during dissection. Endoscopically en-bloc resection was achieved in 11/19 (57.8%) cases and 10/19 cases (52.6%) resections were R0 histologically. In 8/19 patients snare excision was used to facilitate resection with a median of 2 resection pieces. Microwave energy was utilized to pre-coagulate and control active bleeding successfully in 17/19 (89.5%) cases and haemostatic monopolar forceps was required in 2 cases. Histology showed dysplasia in 15/19, NET in 1/19 and T1 cancer in 3/19. 2/3 patients with T1 cancers had endoscopic surveillance with no recurrence and 1 had surgery and no residual tissue. 3/19 patients experienced delayed bleeding all requiring endoscopic hemostasis. No perforation was seen. Conclusions: This early experience with SRS2 shows colorectal submucosal dissections are feasible with an acceptable safety profile. Resection times for lesions ≤4 cm were relatively quick and microwave coagulation appeared to be effective in most cases.