Endoscopic Full-Thickness Resection via Mucosal Eversion
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Solution Overview
Problem
Current endoscopic full-thickness resection methods face challenges in reducing invasiveness and preventing gas leakage into the abdominal cavity, leading to difficulties in observation and closure of the resection hole, and may result in layer misalignment during incision, requiring excessive tissue margins.
Innovation Solution
A method involving endoscopic insertion, everting the tract wall by suturing mucosal layers to evict the target region into the abdominal cavity, followed by precise incision using an incision tool within a formed tunnel to minimize tissue removal and prevent gas leakage, allowing for full-thickness resection without abdominal wall drilling.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If conventional endoscopic full-thickness resection methods are used, then resection of the digestive tract can be performed, but invasiveness is increased and gas leakage into the abdominal cavity occurs
Solution Approach 1:
The mucosal layer is sutured together before the incision step to form a closed tunnel structure. This preliminary closure prevents gas from leaking into the abdominal cavity during the subsequent incision and resection procedures, while still allowing the incision tool to pass through and perform full-thickness resection.
Solution Approach 2:
The digestive tract wall is divided into distinct layers (mucosal layer, submucosal layer, muscular layer) that are treated separately. The mucosal layer is sutured to form a closure structure, while the deeper layers are incised and resected, allowing selective management of different tissue layers to prevent gas leakage while maintaining resection capability.
2Object-affected harmful factors
If excessive tissue margins are taken during resection, then complete lesion removal is ensured, but patient invasiveness is increased
Solution Approach 1:
The mucosal layer is sutured together before incision to create a confined tunnel space. This preliminary structure allows for precise visualization and controlled incision along the exact lesion margins, eliminating the need for excessive safety margins while ensuring complete lesion removal through direct endoscopic visualization.
3Device complexity
If the tract wall is incised without preliminary suturing, then the procedure is simpler, but layer misalignment occurs during incision
Solution Approach 1:
The mucosal layer is sutured together before the incision step to establish a stable, pre-aligned structural framework. This preliminary suturing ensures that all tissue layers remain properly aligned and registered during the subsequent incision process, preventing layer misalignment while maintaining procedural feasibility.
Data Source
AI summary
A method of resecting entire layers of a digestive tract includes: an insertion step of inserting an endoscope into the digestive tract; an everting step performed after the insertion step, to suture mucosal layers located on both sides of a target region including a lesion, cover the target region with the mucosal layers, and evert a tract wall including the target region to a side of an abdominal cavity, in the digestive tract; and an incision step performed after the everting step, to position an incision tool between the target region and the mucosal layers to incise the tract wall around the lesion by the incision tool.