磁锚定技术辅助内镜下胃黏膜剥离术的实验研究

Experimental study on magnetic anchoring technique for endoscopic gastric mucosal dissection

摘要:

目的 探讨磁锚定技术（MAT）在内镜下胃黏膜剥离术中应用的可行性。方法 自行设计加工适用于胃内镜黏膜下剥离术（ESD）的磁锚定装置。以Beagle犬离体胃为实验模型，胃镜下利用软组织夹将靶磁体（TM）钳夹固定于假定的病变黏膜边缘，胃体外放置锚定磁体（AM），用来吸引牵拉TM，改变牵拉方向，并维持足够的组织张力，从而完成ESD。结果 成功设计并加工出AM和TM。通过胃镜的钳道，利用软组织夹可将TM固定于病变黏膜边缘，钳夹方便，固定牢靠。胃体外AM能够灵活牵引TM，改变AM位置能灵活调节TM来控制黏膜牵拉力的方向和大小，可以清晰显示黏膜剥离面。整个操作过程顺利，未出现黏膜撕脱现象。结论 MAT可用于胃ESD，能够为黏膜剥离面提供足够的组织张力，并充分显露剥离面术野，该技术操作简单，具有极大的临床应用潜力。

Abstract:

Objective To explore the feasibility of magnetic anchoring technique in endoscopic gastric mucosal dissection.Methods Self-designed magnetic anchoring device suitable for endoscopic gastric mucosal dissection. Using the Beagle dog’s isolated stomach as an experimental model, a soft tissue clip was used to fix the target magnet to the hypothesized lesion mucosa under gastroscopy. An anchor magnet was placed outside the stomach to attract the target magnet, change the pulling direction and maintain sufficient tissue tension, thus completing endoscopic gastric mucosal dissection.Results Successfully designed and processed the anchor magnet and target magnet. The target magnet can be fixed to the edge of the diseased mucosa by using a soft tissue clamp through the gastroscope's clamping channel. The clamping is convenient and secure. The gastric extracorporeal anchoring magnet can flexibly pull the target magnet, changing the position of the anchoring magnet can flexibly adjust the direction and size of the target magnet's pulling force on the mucosa, and the mucosal peeling surface can be clearly displayed. The entire operation was smooth without mucosal avulsion.Conclusion Magnetic anchoring technology can be used for endoscopic gastric mucosal dissection, which can provide sufficient tissue tension for the mucosal dissection surface and fully expose the surgical field of the dissection surface. The technique is simple to operate and has great potential for clinical application.