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. 2018 Dec;6(12):E1431-E1435.
doi: 10.1055/a-0761-9649. Epub 2018 Dec 10.

Novel three-dimensional imaging system may facilitate gastric endoscopic submucosal dissection procedure: an ex vivo animal study

Naoki Akizue  1 , Tomoaki Matsumura  1 , Daisuke Maruoka  1 , Kentaro Ishikawa  1 , Dao Viet Hang  2 , Kenichiro Okimoto  1 , Keiko Saito  1 , Tomoo Nakagawa  1 , Makoto Arai  1 , Naoya Kato  1
Affiliations

Novel three-dimensional imaging system may facilitate gastric endoscopic submucosal dissection procedure: an ex vivo animal study

Naoki Akizue et al. Endosc Int Open. 2018 Dec.

Abstract

Background and study aims Endoscopic submucosal dissection (ESD) requires advanced skills to perform safely without complications. The current study evaluated the usefulness of a novel three-dimensional (3D) imaging system in ESD using porcine stomachs. Methods Four endoscopists (two trainees and two experts) performed eight ESD procedures using both 3D and 2D images. The usefulness of 3D image versus 2D image was evaluated by visibility and procedure time. In addition, occurrence of eyestrain and dizziness in 3D image was assessed. Results En bloc resection was successfully achieved, without perforation, in all cases. The evaluation score in the 3D image group was better than that in the 2D image group, particularly depth perception was statistically significantly good. No significant difference was found in the working speed between the 2D and 3D image groups. Two examiners experienced eyestrain and dizziness while using the 3D image. Conclusions All the ESD procedures were performed safely. Depth perception using the 3D image was better than with the 2D image. A novel 3D image system may facilitate ESD.

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Conflict of interest statement

Competing interests This research was conducted using grants from Chiba Foundation for Health Promotion & Disease Prevention.

Figures

Fig. 1
Fig. 1
2D and 3D endoscopic images. 2D images are converted to 3D images by a novel 3D imaging processor. The 3D image can be recognized by using 3D glasses.
Fig. 2
Fig. 2
Order of the procedures. Trainee A and expert A performed ESD using a 2D monitor at first and a 3D monitor during the second procedure. In contrast, trainee B and expert B performed ESD using a 3D monitor at first and a 2D monitor during the second procedure.
Fig. 3
Fig. 3
Average evaluation by operators. When using the 3D image, depth perception, ease of dissection, and ease of dissection were all good compared with results obtained using the 2D image. In particular, depth perception was significantly better with a 3D image.
Fig. 4
Fig. 4
Average working speed of operators. Iincision speed tended to be fast with a 3D image. Dissection speed tended to be fast with a 2D image, but no significant difference was seen between the 2D and 3D images in that measure.
See this image and copyright information in PMC

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