Clinical efficacy of endoscopic hand suturing and development for new techniques of therapeutic endoscopy

• Project/Area Number: 18K07919
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Nippon Medical School
• Principal Investigator: Goto Osamu 日本医科大学, 医学部, 講師 (00589658)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 内視鏡的手縫い縫合法 / 内視鏡的粘膜下層剥離術 / ESD後出血 / トラクション / 内視鏡的手縫い縫合 / ESD / 早期胃癌 / 大腸腫瘍 / 内視鏡的全層切除

Outline of Final Research Achievements

This project was aimed to establish safe endoscopic treatments and to explore novel endoscopic procedure by using endoscopic hand suturing (EHS). Single-arm pilot studies demonstrated that EHS was feasible for mucosal defect both after gastric and colorectal endoscopic submucosal dissection (ESD) and might prevent postoperative bleeding. Furthermore, ex-vivo and in-vivo studies demonstrated that EHS was useful for creating a traction in EHS, performing muscular resection, and shortening the suturing time by combination with the use of 3D endoscopy.

Academic Significance and Societal Importance of the Research Achievements

本研究により、胃および大腸ESD後出血に対する効果的な予防策が講じられる可能性を示唆することができた。今後ますます増えていくであろう抗血栓薬服用者に対するESDは術後出血高危険群であるが、EHSにより病変切除創を閉鎖することで術後出血を回避できる可能性がある点において社会的意義は大きいものと考えられた。また、本手技の応用によってさらに内視鏡診療の可能性が拡大した点において学術的意義も大きいものと思われた。

Research Products

• [Journal Article] Cutting-Edge Technologies for Gastrointestinal Therapeutic Endoscopy (2021)
  • Author(s): Goto Osamu、Koizumi Eriko、Higuchi Kazutoshi、Noda Hiroto、Onda Takeshi、Omori Jun、Kaise Mitsuru、Iwakiri Katsuhiko
  • Journal Title: Journal of Nippon Medical School Volume: 88 Issue: 1 Pages: 17-24
  • DOI: 10.1272/jnms.JNMS.2021_88-109
  • NAID: 130007996954
  • ISSN: 1345-4676, 1347-3409
  • Year and Date: 2021-02-24
  • Peer Reviewed
• [Journal Article] Novel method of sampling the gastrointestinal muscle layer: feasibility of endoscopic muscular resection with a ligation device in an in vivo porcine model (2021)
  • Author(s): Osamu Goto、Kazutoshi Higuchi、Atsushi Tatsuguchi、Eriko Koizumi、Hiroto Noda、Takeshi Onda、Jun Omori、Mitsuru Kaise、Kasuhiko Iwakiri
  • Journal Title: Journal of Nippon Medical School Volume: -
  • NAID: 130008117368
  • Peer Reviewed
• [Journal Article] 特集 上部消化管腫瘍における先進的内視鏡治療の進歩 2 .注目される内視鏡治療の実際(3)胃ESD における内視鏡的手縫い縫合法 (2020)
  • Author(s): 樋口 和寿、後藤 修、貝瀬 満、岩切 勝彦
  • Journal Title: 臨床消化器内科 Volume: 36 Issue: 1 Pages: 48-53
  • DOI: 10.19020/CG.0000001638
  • ISSN: 0911-601X, 2433-2488
  • Year and Date: 2020-12-20
• [Journal Article] A novel endoscopic hand-suturing technique for defect closure after colorectal endoscopic submucosal dissection: a pilot study (2020)
  • Author(s): Abe Seiichiro、Saito Yutaka、Tanaka Yusaku、Ego Mai、Yanagisawa Fumito、Kawashima Kazumasa、Takamaru Hiroyuki、Sekiguchi Masau、Yamada Masayoshi、Sakamoto Taku、Matsuda Takahisa、Goto Osamu、Yahagi Naohisa
  • Journal Title: Endoscopy Volume: - Issue: 09 Pages: 780-785
  • DOI: 10.1055/a-1120-8533
  • Peer Reviewed
• [Journal Article] Endoscopic hand-suturing is feasible, safe, and may reduce bleeding risk after gastric endoscopic submucosal dissection: a?multicenter pilot study (with video) (2020)
  • Author(s): Goto Osamu、Oyama Tsuneo、Ono Hiroyuki、Takahashi Akiko、Fujishiro Mitsuhiro、Saito Yukata、Abe Seiichiro、Kaise Mitsuru、Iwakiri Katsuhiko、Yahagi Naohisa
  • Journal Title: Gastrointestinal Endoscopy Volume: - Issue: 5 Pages: 1195-1202
  • DOI: 10.1016/j.gie.2019.12.046
  • Peer Reviewed
• [Journal Article] Three-Dimensional Flexible Endoscopy Can Facilitate Efficient and Reliable Endoscopic Hand Suturing: An ex-vivo Study (2020)
  • Author(s): Jun Omori, Osamu Goto, Kazutoshi Higuchi, Takamitsu Umeda, Naohiko Akimoto, Masahiro Suzuki, Kumiko Kirita, Eriko Koizumi, Hiroto Noda, Teppei Akimoto, Mitsuru Kaise and Katsuhiko Iwakiri
  • Journal Title: Clinical Endoscopy Volume: -
  • Peer Reviewed
• [Journal Article] 内視鏡的手縫い縫合法 (2020)
  • Author(s): 後藤修, 貝瀬満, 岩切勝彦
  • Journal Title: Gastroenterological Endoscopy Volume: -
  • NAID: 130007878398
• [Presentation] Endoscopic hand suturing - current status and future perspectives (2021)
  • Author(s): Osamu Goto, Mitsuru Kaise, Katsuhiko Iwakiri
  • Organizer: The 15th JGES-ASGE Joint Symposium
  • Int'l Joint Research / Invited
• [Presentation] より大きく消化管筋層を採取する工夫-内視鏡的筋層切除に関する動物実験 (2020)
  • Author(s): 後藤修 樋口和寿 小泉英里子 門馬絵理 花田優理子 竹之内菜菜 星野慎太郎 川見典之 貝瀬満 岩切勝彦
  • Organizer: 第74回日本食道学会学術集会
• [Presentation] Mucosal defect closure by endoscopic hand-suturing may reduce bleeding risk after gastric endoscopic submucosal dissection: a multicenter pilot study (2020)
  • Author(s): Goto Osamu、Oyama Tsuneo、Ono Hiroyuki、Takahashi Akiko、Fujishiro Mitsuhiro、Saito Yutaka、Abe Seiichiro、Kaise Mitsuru、Iwakiri Katsuhiko、Yahagi Naohisa
  • Organizer: Digestive Disease Week 2020
• [Presentation] 軟性持針器を用いた内視鏡的手縫い縫合法の開発 -現状と展望- (2020)
  • Author(s): 後藤修, 小山恒男, 小野裕之
  • Organizer: 第99回日本消化器内視鏡学会総会
• [Presentation] Endoscopic hand-suturing (2020)
  • Author(s): Osamu Goto, Mitsuru Kaise, Katsuhiko Iwakiri
  • Organizer: 第99回日本消化器内視鏡学会総会
  • Invited
• [Presentation] Mucosal defect closure by endoscopic hand-suturing may reduce bleeding risk after gastric endoscopic submucosal dissection: a multicenter pilot study (2020)
  • Author(s): Osamu Goto, Tsuneo Oyama, Hiroyuki Ono, Akiko Takahasi, Mitsuhiro Fujishiro, Yutaka Saito, Seiichiro Abe, Mitsuru Kaise, Katsuhiko Iwakiri, Naohisa Yahagi
  • Organizer: DDW2020
  • Int'l Joint Research
• [Presentation] 大腸内視鏡的粘膜下層剥離術後の粘膜欠損部に対する内視鏡的手縫い縫合法のpilot試験 (2019)
  • Author(s): 阿部 清一郎, 斎藤 豊, 後藤 修
  • Organizer: JDDW2019
• [Presentation] 内視鏡的手縫い縫合における3D内視鏡の有用性に関する机上実験 (2019)
  • Author(s): 大森 順, 後藤 修, 桐田 久美子, 小泉 英里子, 野田 啓人, 樋口 和寿, 梅田 隆満, 飽本 哲兵, 秋元 直彦, 鈴木 将大, 貝瀬 満, 岩切 勝彦
  • Organizer: 第97回日本消化器内視鏡学会総会
• [Presentation] 胃ESDにおけるFlexible traction methodの有用性の検証 (2019)
  • Author(s): 樋口 和寿, 後藤 修, 貝瀬 満
  • Organizer: 第97回日本消化器内視鏡学会総会
• [Presentation] Usefulness of the flexible traction method in gastric endoscopic submucosal dissection: an in-vivo animal study (2019)
  • Author(s): Kazutoshi Higuchi, Osamu Goto, Kumiko Kirita, Eriko Koizumi, Hiroto Noda, Takamitsu Umeda, Teppei Akimoto, Jun Omori, Mitsuru Kaise, Katsuhiko Iwakiri
  • Organizer: DDW2019
  • Int'l Joint Research
• [Presentation] A pilot study of novel endoscopic hand-suturing for defect closure after colorectal endoscopic submucosal dissection (2019)
  • Author(s): Abe S, Goto O, et al.
  • Organizer: ESGE Days 2019
  • Int'l Joint Research
• [Presentation] Usefulness of the flexible traction method in gastric endoscopic submucosal dissection: an in-vivo animal study (2019)
  • Author(s): Higuchi K, Goto O, et al.
  • Organizer: DDW 2019
  • Int'l Joint Research
• [Presentation] 胃ESDにおけるFlexible traction methodの有用性の検証 (2019)
  • Author(s): 樋口和寿、後藤修ら.
  • Organizer: 第97回日本消化器内視鏡学会総会