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Magnetic-anchor-guided endoscopic submucosal dissection shows promise for gastric cancer
Date:1/27/2009

ric body (stomach) were seen on an inpatient basis for an ESD at the National Cancer Center Hospital in Tokyo, Japan. The final aim was to achieve an en bloc resection (removal of the entire cancerous growth).

The MAG system is composed of both internal and external components. The intracorporeal magnetic anchor consists of a hand-made stainless steel magnetic weight of six grams, and microforceps connected by a short thread. The magnetic anchor is delivered into the stomach of the patient through a hollow tube (overtube) that incorporates the endoscope and the magnetic weight. The extracorporeal magnetic control system includes a 35 cm extracorporeal magnet whose movement is controlled by the up-down motion of the external magnet itself as well as a movable examination table. The mobile examination table enabled control of the internal magnetic anchor so as to achieve ideal mucosal lifting to allow for the gastric submucosal dissection.

The procedure began in standard ESD fashion with the injection of a liquid cushion into the submucosa and initial entry into the submucosa with the electrocautery device. The procedure was then carried out using the new MAG-ESD technique. The magnetic anchor was clipped to the free edge of the lesion in the stomach which can now be controlled by the large magnet outside the patient to provide an appropriate amount of tension. This makes it possible to peel back the portion of the lesion now separated from the submucosa, clearing the view of the endoscopist for safer removal of the lesion. After endoscopic resection, both the resected tissue and the magnetic anchor(s) were removed from the stomach.

The demographic and clinical features of each patient were recorded in a case report form. Two gastrointestinal endoscopists assessed the data as to whether the magnetic anchor facilitated a gastric ESD, and was classified either "supportive" or "not supportive." The en bloc resection rate, complications, total
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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