Magnetic anchor technique assisted endoscopic submucosal dissection for early esophageal cancer

Abstract

Abstract Esophageal cancer has high incidence globally and is often diagnosed at an advanced stage. This study intends to explore the feasibility and applicability of magnetic anchor technique (MAT)-assisted ESD for early esophageal cancer. Isolated pig esophagus was used as the experimental model, and the magnetic anchor device was designed by us. The soft tissue clip and the target magnet (TM) were connected by a thin wire through a small hole at the tail end of the TM. Under gastroscopic guidance, the soft tissue clip was clamped to the edge of the lesioned mucosa, which was marked in advance. By changing the position of the anchor magnet (AM) outside the esophagus, the pulling force and pulling direction of the TM could be changed, thus exposing the mucosal peeling surface and assisting the ESD. Herein, MAT-assisted ESD was successfully completed for 10 isolated esophageal putative mucosal lesions. During the entire experiment, the TM remained firmly connected with the soft tissue clip and did not affect the opening, closing, and release of the soft tissue clip. The interaction between the TM and AM could provide sufficient tissue tension and completely expose the mucosa, which greatly assists the surgeon with the operation. There was no avulsion of the mucosa, and mucosal lesions were intact when peeled. We found MAT-assisted ESD safe and feasible for early esophageal cancer. It could greatly improve the endoscopic operation experience and showed good clinical application prospects.