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Three-Dimensional Flexible Endoscopy Can Facilitate Efficient and Reliable Endoscopic Hand Suturing: An ex-vivo Study

Clinical Endoscopy 2020년 53권 3호 p.334 ~ 338
Omori Jun, Goto Osamu, Higuchi Kazutoshi, Umeda Takamitsu, Akimoto Naohiko, Suzuki Masahiro, Kirita Kumiko, Koizumi Eriko, Noda Hiroto, Akimoto Teppei, Kaise Mitsuru, Iwakiri Katsuhiko,
소속 상세정보
 ( Omori Jun ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Goto Osamu ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Higuchi Kazutoshi ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Umeda Takamitsu ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Akimoto Naohiko ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Suzuki Masahiro ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Kirita Kumiko ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Koizumi Eriko ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Noda Hiroto ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Akimoto Teppei ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Kaise Mitsuru ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology
 ( Iwakiri Katsuhiko ) - Nippon Medical School Graduate School of Medicine Department of Gastroenterology

Abstract


Background/Aims: Three-dimensional (3D) flexible endoscopy, a new imaging modality that provides a stereoscopic view, can facilitate endoscopic hand suturing (EHS), a novel intraluminal suturing technique. This ex-vivo pilot study evaluated the usefulness of 3D endoscopy in EHS.

Methods: Four endoscopists (two certified, two non-certified) performed EHS in six sessions on a soft resin pad. Each session involved five stitches, under alternating 3D and two-dimensional (2D) conditions. Suturing time (sec/session), changes in suturing time, and accuracy of suturing were compared between 2D and 3D conditions.

Results: The mean suturing time was shorter in 3D than in 2D (9.8±3.4 min/session vs. 11.2±5.1 min/session) conditions and EHS was completed faster in 3D conditions, particularly by non-certified endoscopists. The suturing speed increased as the 3D sessions progressed. Error rates (failure to grasp the needle, failure to thread the needle, and puncture retrial) in the 3D condition were lower than those in the 2D condition, whereas there was no apparent difference in deviation distance.

Conclusions: 3D endoscopy may contribute to increasing the speed and accuracy of EHS in a short time period. Stereoscopic viewing during 3D endoscopy may help in efficient skill acquisition for EHS, particularly among novice endoscopists.

키워드

Endoscopic suturing; Learning curve; Three-dimensional endoscopy

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