ESD was performed with a conventional single-channel endoscope (GIF-H260Z or -Q260J; Olympus, Tokyo, Japan) or a two-channel endoscope (2TQ260 M; Olympus). We mainly used an IT knife 2 (KD-611 L; Olympus), and electrosurgical current was applied using an electrosurgical generator (VIO 300D; ERBE, T¨ubingen, Germany). In addition, we used other electrosurgical knives as necessary, including an IT knife (KD-610 L or KD-611 L; Olympus), a Hook knife (KD-620LR; Olympus), or a Flush knife (DK-2618; Fujifilm Inc., Tokyo, Japan), with an ICC200 (ERBE) electrosurgical generator. The injection solutions contained glycerin and hyaluronic acid sodium (0.4%) with 1% indigo carmine dye. The ulcers that developed after ESD were endoscopically examined and any visible vessels were heat-coagulated using hemostatic forceps (FD-410LR; Olympus). The resected specimens were stretched, pinned flat on a corkboard, and measured.
Kd 611l
Manufactured by Olympus
Sourced in Japan, Germany
The KD-611L is a laboratory centrifuge designed for general-purpose applications. It features a brushless DC motor and a microprocessor control system to provide consistent and reliable performance. The centrifuge can accommodate various rotor sizes and sample volumes, making it suitable for a wide range of laboratory tasks.
Automatically generated - may contain errors
Lab products found in correlation
Gif q260j, by Olympus (17 mentions)
Fd 410lr, by Olympus (13 mentions)
Kd 650l, by Olympus (12 mentions)
Vio300d, by Erbe (10 mentions)
Kd 620lr, by Olympus (8 mentions)
Kd 610l, by Olympus (6 mentions)
Gif 2tq260m, by Olympus (5 mentions)
Vio 200d, by Erbe (5 mentions)
Gif h260z, by Olympus (3 mentions)
Mucoup, by Johnson & Johnson (3 mentions)
Nm 4l 1, by Olympus (3 mentions)
Kd 650q, by Olympus (3 mentions)
Icc 200, by Erbe (3 mentions)
It knife 2, by Olympus (3 mentions)
Gif q260, by Olympus (2 mentions)
Nm 200l 0525, by Olympus (2 mentions)
Kd 1l 1, by Olympus (2 mentions)
Hx 600 135, by Olympus (2 mentions)
D 201 11304, by Olympus (2 mentions)
Apc300, by Erbe (2 mentions)
35 protocols using kd 611l
1
Endoscopic Submucosal Dissection for Gastrointestinal Lesions
2
Endoscopic Submucosal Dissection for Gastric Neoplasia
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ESD was done with a single channel endoscope with jet function available (GIF Q260J, Olympus Optical Co. Ltd., Tokyo, Japan). Chromoendoscopy (using indigo carmine) and magnification endoscopy with narrow-band imaging (ME-NBI, GIF H260Z, Olympus Optical Co. Ltd., Tokyo, Japan) were used to define the carcinomatous area. A dual knife (KD-611L, Olympus Optical Co. Ltd., Tokyo, Japan) was used to mark the lesion. Saline mixed with epinephrine (0.01 mg/mL) and 0.5% indigo carmine was injected into the submucosa to lift the lesion. A circumferential mucosal incision was made around the lesion using a dual knife and/or IT knife 2 (KD-650L, Olympus Optical Co. Ltd., Tokyo, Japan). Lesions were completely removed by submucosal dissection using an IT knife 2 and/or a dual knife. Endoscopic hemostasis was performed either with hemostatic forceps (FD-410LR, Olympus Optical Co. Ltd., Tokyo, Japan) or the knife itself for bleeding or an exposed vessel. All visible vessels on the artificial ulcer were coagulated using hemostatic forceps, irrespective of the presence or absence of bleeding. For synchronous multiple lesions, marking was performed for all lesions initially. Resections subsequently were performed in the same way (Fig. 1 A–H).
3
Endoscopic Submucosal Dissection for Gastric Lesions
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All procedures were performed by four endoscopic specialists with experience in performing more than 100 cases of ESD, using a gastroscope (GIF-Q240 or GIF-Q260; Olympus Optical, Tokyo, Japan). The characteristics of all lesions, such as the site of occurrence, gross findings, presence of ulcers, and erosions, were inspected, and the gross findings were categorized as I, IIa, IIb, IIc, and III according to the Paris endoscopic classification of early gastric cancer.
A 5-mm margin was marked outside the lesion using a snare tip; normal saline was injected into the submucosa surrounding the lesion. An incision was made circumferentially around the lesion using a needle knife (KD-1L-1; Olympus Optical). Submucosal dissection was performed using an IT knife (insulated-tip diathermic knife; KD-610L; Olympus Optical) and an IT knife-2 (KD-611L; Olympus Optical).
A 5-mm margin was marked outside the lesion using a snare tip; normal saline was injected into the submucosa surrounding the lesion. An incision was made circumferentially around the lesion using a needle knife (KD-1L-1; Olympus Optical). Submucosal dissection was performed using an IT knife (insulated-tip diathermic knife; KD-610L; Olympus Optical) and an IT knife-2 (KD-611L; Olympus Optical).
4
Gastric ESD Protocol with Dual Knife
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All study patients had undergone gastric ESD under deep sedation with propofol or general anesthesia. The procedures were performed using a single-channel endoscope (GIF-H260Z or GIF-Q260J; Olympus Medical, Tokyo, Japan) and an electrosurgical unit (VIO 300D; ERBE, Elektromedizin, Tübingen, Germany). Carbon dioxide was insufflated during the procedures.
The ESD protocol was as follows: 1) marking dots were placed circumferentially approximately 5 mm beyond the lesion, using a DualKnife (KD-441Q; Olympus Medical); 2) a mixture of 0.4% hyaluronate sodium solution (MucoUp; Johnson & Johnson K.K., Tokyo, Japan) and glycerol (Chugai Pharmaceutical, Tokyo, Japan) was injected into the submucosa; 3) the mucosa was then incised circumferentially and submucosal dissection performed using a DualJnife and an ITknife2, respectively (KD-611L; Olympus Medical). After en-bloc resection, visible vessels were coagulated using hemostatic forceps (Coagrasper; FD-411QR; Olympus Medical). Resection time was defined as the time from the start of submucosal injection to the resection of the lesion.
The ESD protocol was as follows: 1) marking dots were placed circumferentially approximately 5 mm beyond the lesion, using a DualKnife (KD-441Q; Olympus Medical); 2) a mixture of 0.4% hyaluronate sodium solution (MucoUp; Johnson & Johnson K.K., Tokyo, Japan) and glycerol (Chugai Pharmaceutical, Tokyo, Japan) was injected into the submucosa; 3) the mucosa was then incised circumferentially and submucosal dissection performed using a DualJnife and an ITknife2, respectively (KD-611L; Olympus Medical). After en-bloc resection, visible vessels were coagulated using hemostatic forceps (Coagrasper; FD-411QR; Olympus Medical). Resection time was defined as the time from the start of submucosal injection to the resection of the lesion.
5
ESD Procedure and Ulcer Management
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In all patients, ESD was performed using an IT knife-2 (KD-611L; Olympus, Tokyo, Japan), an endoscope with a water-jet function (GIF-Q260J; Olympus), and a high-frequency generator (VIO300D; ERBE Elektromedizin, Tubingen, Germany), as described previously (27 (link)). Immediately after tumour resection, visible vessels were coagulated using hot biopsy forceps or an IT knife-2. In some patients, however, ulcer protection was performed by the closure of the ESD ulcer with endoclips (full or partially; closure group) or by covering an ulcer with a polyglycolic acid (PGA) sheet. On the day after ESD (day 1), a second-look endoscopy, complete blood cell count, and chest X-ray were performed. Eating was prohibited on the day of and day following ESD, and intravenous omeprazole (40 mg/day) was administered. From day 2, a soft-food diet was started, and either oral VPZ (20 mg daily) or PPI (20 mg rabeprazole or 30 mg lansoprazole or 20 mg esomeprazole daily; certified dose in Japan) was administered until 8 weeks after ESD. Of note, there were no definite criteria for selecting PPI or VPZ, and either was selected at the discretion of the principal physician before the ESD procedure.
6
Comprehensive Gastric Endoscopy Protocol
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Gastroscopy (GIF Q260J, Olympus); EUS (EU-ME1/A75, Olympus); Dual knife (KD-650Q); Insulation-tip knife (KD-611L, Olympus); Hook knife (KD-620L, Olympus); Transparent cap (D-201-11802, Olympus); Argon plasma coagulation unit (APC300; ERBE); High-frequency generator (ICC 200/300, Olympus); Injection needle (NM-4L-1, Olympus); Hemostatic clips (HX-600-90); etc.
7
Endoscopic Resection Techniques Protocol
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We selected these instruments to extend our previous study 4, 5 . The following instruments were used: Electronic gastroscope (Olympus GIF-Q260J, Olympus company, Japan), hyaline cap (D-201-11304, Olympus company, Japan), spiculiform cutting knife (KD-1 L-1, Olympus company, Japan), IT knife (KD-611 L, Olympus company, Japan), hook knife (KD-620 LR, Olympus company, Japan), injection needle (NM-200 L-0525, Olympus company, Japan), snare (AS-1-S, ASJ-1-S, COOK company, United States), hot biopsy forceps (FD-410 LR, Olympus company, Japan), hemostatic clip (HX-610-90, Olympus company, Japan; HX-600-135, Olympus company, Japan; Boston Resolution TM , Boston company, United States), high frequency electric knife (ERBE VIO 200S, ERBE company, Germany) and, Argon Plasma Coagulation instrument (ERBE APC2, ERBE company, Germany).
8
Endoscopic Resection Techniques for gGISTs
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Two types of ER techniques were used: ESD and endoscopic full-thickness resection (EFTR). ESD was used for gGISTs originating from the muscularis mucosae (MM) or muscularis propria (MP) and protruding into the lumen. EFTR was used for gGISTs originating from deep MP with extraneous growth, or gGIST in which the tumor is found to be tightly adherent to the serous layer and cannot be separated during ESD.
The ER procedure was performed in accordance with previous reports (12, (link)13) (link). A single channel endoscope (GIF-Q260J, Olympus, Japan) was used. Other equipment included: insulated-tip knives (ERBE Germany), dual knives (KD-611L, Olympus, Japan), high-frequency generator device (ERBE VIO® 200D), carbon dioxide insufflator, hot biopsy forceps, injection needles, metallic clips and nylon loops.
The ER procedure was performed in accordance with previous reports (12, (link)13) (link). A single channel endoscope (GIF-Q260J, Olympus, Japan) was used. Other equipment included: insulated-tip knives (ERBE Germany), dual knives (KD-611L, Olympus, Japan), high-frequency generator device (ERBE VIO® 200D), carbon dioxide insufflator, hot biopsy forceps, injection needles, metallic clips and nylon loops.
9
Endoscopic Resection Techniques and Devices
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A single-accessory channel endoscope (Q260J; Olympus) and/or a dual-channel endoscope (GIF-2T240, Olympus) were used during the procedures. A transparent cap (ND-201-11802; Olympus) was attached to the tip of the endoscope. An insulated-tip knife (KD-611L, IT2; Olympus), hook knife (KD-620LR; Olympus), dual knife (KD-650Q; Olympus), or hybrid knife (ERBE, Tübingen, Germany) was used to dissect the submucosal layer and peel the tumor. A titanium clip (HX-600-135; Olympus and M00522600), an endoloop (Leo Medical Co., Ltd, Changzhou, China), and an over-the-scope clip (OTSC) (12/6 t-type, Ovesco Endoscopy AG) were used for wound closure. Other devices and accessories that were used included a high-frequency electronic cutting device (ICC 200; ERBE), an argon plasma coagulation unit (APC 300; ERBE, Tübingen, Germany), a hot biopsy forceps (FD-410LR; Olympus), a foreign body forceps (FG-B-24, Kangjin, Changzhou, China), a snare (SD-230U-20; Olympus), and a carbon dioxide insufflator (Olympus).
10
Endoscopic Submucosal Dissection Technique
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We performed ESD using a single-channel endoscope (GIF-Q260J; Olympus Corp.) or via multiangle two-channel endoscopy (GIF-2TQ260M; Olympus Corp.). The injection solution contained glycerol, hyaluronic acid sodium (0.4% [w/v]), and 0.001% (w/v) epinephrine and was locally injected into the submucosal layer using a disposable 23-gauge needle (Top Corp., Tokyo, Japan). The ITknife2 (KD-611L; Olympus Corp.) was the primary cutting device used, but we occasionally employed a DualKnife (KD-650U; Olympus Corp.). An electrosurgical current was applied with the aid of an electrosurgical generator (VIO300D or ICC200; ERBE Elektromedizin GmbH, Tubingen, Germany). Ulcers that developed after ESD were carefully examined endoscopically and any visible vessels clipped (EZ Clip; Olympus Corp.) and/or heat-coagulated using hemostatic forceps (Coagrasper, FD410LR; Olympus Corp.) in all patients in both groups.
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