Journal
WORLD JOURNAL OF GASTROENTEROLOGY
Volume 23, Issue 16, Pages 2883-2890Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v23.i16.2883
Keywords
Endoscopic submucosal dissection; Gastric cancer; Magnetic anchor guidance; Esophageal cancer; Magnets; Traction; Natural orifice transluminal endoscopic surgery
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Endoscopic submucosal dissection (ESD) is a well-established, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection (MAG-ESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon's second hand. Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology.
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