Oblique-viewing echoendoscopes (GF-UCT260, GF-UCT240; Olympus, Tokyo, Japan; EG-580UT, FUJIFILM Medical, Tokyo, Japan) and forward-viewing echoendoscopes (TGF-UC260J; Olympus) were used. Generally, an oblique-viewing echoendoscope was used in EUS-BD and forward-viewing was used in non-EUS-BD. A 19-gauge EUS fine-needle aspiration needle (EZ Shot 3 Plus; Olympus) was used as the puncture needle, and a 0.025-inch guidewire (M Through; MEDICO'S HIRATA, Osaka, Japan) was used. EUS-IV WoD was attempted in all cases after contrast medium injection. When the stent delivery system could not be inserted WoD, it was inserted after fistula dilation using a mechanical dilator (ES Dilator; ZEON Medical, Tokyo, Japan) or a 4-mm dilation balloon (REN; KANEKA, Osaka, Japan) (i. e. non-adherence to EUS-IV WoD). In non-EUS-BD, including EUS-GBD, EUS-GE, and EUS-CD, a half pigtail plastic stent (PS) (Double pit; Gadelius, Tokyo, Japan) was placed in the SEMS as an anchor for preventing AEs such as stent migration.
Ez shot 3 plus
Manufactured by Olympus
Sourced in Japan
The EZ Shot 3 Plus is a compact, automated liquid handling system designed for a wide range of laboratory applications. It features a high-precision pipetting mechanism and a user-friendly interface to assist with various liquid handling tasks.
Automatically generated - may contain errors
Lab products found in correlation
Gf uct260, by Olympus (11 mentions)
Visiglide2, by Olympus (3 mentions)
Eg 580ut, by Fujifilm (2 mentions)
Tgf uc260j, by Olympus (1 mentions)
Maj 935, by Olympus (1 mentions)
Maj 1720, by Olympus (1 mentions)
Um 2r, by Olympus (1 mentions)
Echotip ultra, by Cook Medical (1 mentions)
Echotip procore, by Cook Medical (1 mentions)
Eu me2, by Olympus (1 mentions)
Visiglide, by Olympus (1 mentions)
Novagold, by Boston Scientific (1 mentions)
Radifocus hemostasis valve 2, by Terumo (1 mentions)
Hanarostent, by Boston Scientific (1 mentions)
Gf uct240, by Olympus (1 mentions)
17 protocols using ez shot 3 plus
1
Echoendoscope-Guided Biliary Drainage Techniques
2
EUS-Guided Gallbladder Drainage: A Comprehensive Technique
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An echoendoscope (GF-UCT260; Olympus, Tokyo, Japan) connected to the ultrasound scanner (ALOKA F-75; Hitachi Aloka medical, Tokyo, Japan) was used to detect the gallbladder from the stomach or duodenum. A 19-G needle for EUS-guided fine needle aspiration (EZ-shot 3 Plus; Olympus, Tokyo, Japan; Sonotip; Medicos Hirata, Osaka, Japan) was inserted into the gallbladder though the forceps channel of the echoendoscope. After the identification of bile by aspiration, a contrast agent was injected to identify the gallbladder fluoroscopically. The punctured tract was dilated along the inserted guidewire by a cautery dilator (Cyst-Gastro-Set; Century Medical, Tokyo, Japan; Fine-025; Medicos Hirata, Osaka, Japan) or a balloon dilator (Ren [4 mm diameter]; Kaneka, Yokohama, Japan). Subsequently, a 7-Fr double-pigtail plastic stent (PS) (Gadelius Medical Co, Tokyo, Japan), a fully covered dumbbell type metallic stent (MS) (M-Intraductal [10 or 8 mm diameter, 7 cm long]; Medicos Hirata), or a fully covered MS (Niti-S Biliary Covered Stent [10 mm diameter, 10 cm long]; Century Medical, Tokyo, Japan) was deployed to bridge the gallbladder and gastrointestinal cavity. All EUS-GBD procedures were performed by 3 expert endoscopists (RS, KH and HN) who had experience of performing more than 1000 screening EUS procedures and 10 EUS-GBD procedures.
3
Comparing EUS-FNA/FNB Needle Types for Pancreatic Cancer
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We performed EUS-FNA or FNB using three types of needles: 19-gauge and 22-gauge Franseen needles (Acquire, Boston Scientific, Natick, MA) and a 19-gauge conventional FNA needle (EZ Shot 3 Plus, Olympus, Tokyo, Japan) (Figure 1 ).
Among patients who underwent EUS-FNB between June 2018 and March 2020, 10 patients were randomly selected to evaluate the three needles. The choice of needle depended on the performance period. Initially, we used a 19-gauge conventional needle [11 (link)], followed by a 22-gauge Franseen needle. Later on, however, we used a 19-gauge needle for genetic analysis. It has been reported that the diagnostic accuracy of EUS-FNA for pancreatic cancer is lower than that for other pathologies [6 (link)]. In addition, the use of different puncture routes can affect the tissue acquisition. To minimize potential confounding and selection biases among the groups, we only included patients with suspected pancreatic cancer with a tumor size of ≥20 mm located in the body and tail of the pancreas.
Among patients who underwent EUS-FNB between June 2018 and March 2020, 10 patients were randomly selected to evaluate the three needles. The choice of needle depended on the performance period. Initially, we used a 19-gauge conventional needle [11 (link)], followed by a 22-gauge Franseen needle. Later on, however, we used a 19-gauge needle for genetic analysis. It has been reported that the diagnostic accuracy of EUS-FNA for pancreatic cancer is lower than that for other pathologies [6 (link)]. In addition, the use of different puncture routes can affect the tissue acquisition. To minimize potential confounding and selection biases among the groups, we only included patients with suspected pancreatic cancer with a tumor size of ≥20 mm located in the body and tail of the pancreas.
4
EUS-FNAB Protocols for Tissue Sampling
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EUS-FNAB was performed without ROSE, using a linear scanning video echoendoscope (GF-UCT260, TGF-260J; Olympus Medical Systems, Tokyo, Japan) and either a 22 G FNA needle (EZ Shot 3 Plus™; Olympus Medical Systems, Tokyo, Japan) or a 22 G FNB needle (Acquire™; Boston Scientific Corp., Marlborough, MA, USA). The therapist chose the puncture needle. Following stylet withdrawal, 10–20 strokes were made with the needle inside the lesion using a 20-mL syringe under negative pressure. Four needle passes were performed for all lesions. In the first two specimens (isolation group), a technician (one of the two designated endoscopists) measured the SVWC length and isolated the SVWC sample and red components according to the protocol of our previous study.[3 (link)] In the two remaining specimens (no-isolation group), isolation was not performed.
Patients were examined twice for AEs: 3 h after EUS-FNAB sampling and the following morning. The incidence of AEs up to 30 days after EUS-FNAB sampling was evaluated during medical examinations in the outpatient clinic based on established guidelines.[7 (link)]
Patients were examined twice for AEs: 3 h after EUS-FNAB sampling and the following morning. The incidence of AEs up to 30 days after EUS-FNAB sampling was evaluated during medical examinations in the outpatient clinic based on established guidelines.[7 (link)]
5
Liver Impaction Technique for EUS-HGS
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This retrospective study included consecutive patients who underwent EUS-HGS between April 2018 and September 2022. To evaluate the technical feasibility of the liver impaction technique under identical conditions, we used the same devices as in that study: a 19G needle (EZ shot 3 plus, Olympus Medical Systems Corp) and a 0.025-inch guidewire (VisiGlide 1; Olympus). Patients who underwent EUS-HGS using any other puncture needle (including a 22G needle) or guidewire were excluded from the study.
6
EUS-guided Fine Needle Tissue Aspiration for Subepithelial Lesions
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The EUS Probe (UM-2R; Olympus, Tokyo, Japan) and probe driving unit (MAJ-935; Olympus) were used to map the lesion. The image frequency of the probe was 12 MHz. EUS-guided FNTA was performed with a linear array echoendoscope (GF-UCT260; Olympus) and probe driving unit (MAJ-1720; Olympus). Under ultrasound guidance, SETs were punctured with 19-, 20-, 22-, or 25-gauge needles (EchoTip ProCore, Cook Medical Inc, Bloomington, IN; EchoTip Ultra, Cook Medical; EZ Shot3 Plus, Olympus). After visualizing the tip of the catheter, the needle was advanced from the catheter sheath through the wall of the gastrointestinal (GI) tract and into the target lesions under ultrasound guidance. The stylet was removed, and the initial passes were performed by moving the needle back and forth within the target lesion for 15 to 30 seconds. No suction was applied during biopsy unless the biopsy failed to yield any material or if the lesion was cystic.
7
Endoscopic Ultrasound-Guided Hepaticogastrostomy Procedure
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GF-UCT260 (Olympus, Tokyo, Japan) was used for performing endoscopy. A 19-gauge needle for EUS-guided fine-needle aspiration (EUS-FNA) (EZ shot 3 plus; Olympus) was used to puncture the left intrahepatic bile duct during both the EUS-HGS and HJS procedures. After puncturing, the inside of the bile duct was verified using cholangiography, following which, a 0.025-inch guidewire (Visiglide2; Olympus) was placed in the bile duct. A Y-connector attached to the needle made the procedure of switching between bile duct contrasting and the guidewire operation easier and faster. Then, a 6-mm diameter, 8-cm-long, fully-covered SEMS with a 6-Fr delivery system was placed directly without performing dilation. Finally, appropriate placement of the stent was checked endoscopically and under fluoroscopic guidance by confirming that the contrast in the bile duct flowed into the gastrointestinal tract via the stent, and the procedure was completed (
Fig. 2 ). The position of the stent was checked with abdominal computed tomography (CT) 1 day after the procedure.
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GF-UCT260 (Olympus, Tokyo, Japan) was used for performing endoscopy. A 19-gauge needle for EUS-guided fine-needle aspiration (EUS-FNA) (EZ shot 3 plus; Olympus) was used to puncture the left intrahepatic bile duct during both the EUS-HGS and HJS procedures. After puncturing, the inside of the bile duct was verified using cholangiography, following which, a 0.025-inch guidewire (Visiglide2; Olympus) was placed in the bile duct. A Y-connector attached to the needle made the procedure of switching between bile duct contrasting and the guidewire operation easier and faster. Then, a 6-mm diameter, 8-cm-long, fully-covered SEMS with a 6-Fr delivery system was placed directly without performing dilation. Finally, appropriate placement of the stent was checked endoscopically and under fluoroscopic guidance by confirming that the contrast in the bile duct flowed into the gastrointestinal tract via the stent, and the procedure was completed (
8
Comparative Evaluation of FNA and FNB Needles
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A curved linear-array echoendoscope (EG-3870UTK Ultrasound Video Endoscope, PENTAX Medical, Tokyo, Japan), with a working channel width of 3.8 mm, working length of 1250 mm, and tip angle of 130° up, and 130° down was used. Three types of FNA and FNB needles were evaluated respectively by bench simulation. Regarding the size of the needles, 22-gauge needles were used in this study owing to the following reasons. First, this is the most commonly used size and representative needle of each manufacturer, and second, our previous bench study already demonstrated that the 19-gauge needle is not useful for procedures using tight scope angulation.[23 (link)] The tested needles were SonoTip® ProControl (Medi-Globe) (L1), EZ Shot 3 Plus (Olympus Medical Systems, Tokyo, Japan) (L2), Expect™ Standard Handle (Boston Scientific Corporation) (L3), SonoTip® TopGain (F1), Acquire™ (F2), and SharkCore™ (S1). L1, L2, and L3 are major Lancet-type FNA needles each made by a different manufacturer. F1 and F2 are newly developed and conventional Franseen-type needles, respectively. S1 is a fork-tip-type needle, which is different from both the Franseen and the Lancet types. The characteristics of the needles are shown in Table 1 .
9
EUS-Guided Tissue Acquisition Techniques
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All EUS procedures were performed using a curved linear array echoendoscope (GF‐UCT260; Olympus Medical Systems, Tokyo, Japan or EG‐580‐UT; Fujifilm Medical Systems, Tokyo, Japan), which was connected to a processor featuring color Doppler function (EU‐ME2; Olympus Medical Systems or SU‐1, Fujifilm Medical Systems) under moderate sedation. Antithrombotic agents were managed according to the guidelines for gastroenterological endoscopy by the Japan Gastroenterological Endoscopy Society.18 EUS‐guided tissue acquisition was performed using FNA needles (Expect; Boston Scientific Japan, Tokyo, Japan; EZ shot3 Plus; Olympus Corporation, Tokyo, Japan) and/or fine needle biopsy (FNB) needles (Acquire; Boston Scientific Japan, EchoTip Procore; Cook Medical Japan G.K., Tokyo, Japan, SharkCore; Medtronic Japan Corporation, Tokyo, Japan, SonoTip TopGain; Medi‐Globe GmbH, Rosenheim, Germany). The needle type and application of suction were decided at the discretion of endoscopists, and EUS‐FNA was repeated until enough visible core tissue was obtained macroscopically. Rapid on‐site evaluation was performed when available.
10
Endoscopic Ultrasound-Guided Gallbladder Drainage
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All the EUS-GBD procedures were performed by a highly experienced endosonographer (T.H.K.). Before starting the procedure, a significant amount of saline was infused through the PC to inflate the GB and free up the space for stent placement. A linear echoendoscope (GF-UCT 260; Olympus Medical Systems) was placed in the proper position for the procedure, and the GB neck was punctured using a 19-gauge fine-needle aspiration needle (EZ shot3 plus; Olympus Medical Systems). Contrast media were injected through the 19-gauge fine-needle aspiration needle, and the GB was visualized. The 19-gauge fine-needle aspiration needle was then removed, leaving 2 to 3 coils of the guidewire (0.025-in VisiGlide; Olympus Medical Systems) in the GB. Tract dilatation was performed using a 6-F cystotome (Cysto Gastro Set; Endoflex GmbH, Voerde, Germany), and an anti-migrating tubular metal stent (BONA-AL stent; Standard Sci Tech Inc., Seoul, Korea) was placed between the GB and gastrointestinal lumen. Based on the endoscopist’s decision preference, a lumen-apposing metal stent (LAMS) pre-loaded with an electrocautery delivery system (Hot Niti-S Spaxus; Taewoong Medical Co., Ltd., Goyang, Korea) was used (Supplementary Video 2 ).
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