Evaluation of a new method, “non-injection resection using bipolar soft coagulation mode (NIRBS)”, for colonic adenomatous lesions

• Published in: Clinical endoscopy 2023-09, Vol.56 (5), p.623-632
• Main Authors: Tokuhara, Mitsuo, Shimatani, Masaaki, Tominaga, Kazunari, Nakahira, Hiroko, Ohtsu, Takuya, Kouda, Katsuyasu, Naganuma, Makoto
• Format: Article
• Language: English
• Subjects: bipolar snare; colorectal lesion; endoscopic mucosal resection; non-injection; Original; soft coagulation mode
• ISSN: 2234-2400; 2234-2443
• DOI: 10.5946/ce.2022.200

Background/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called “non-injection resection using bipolar soft coagulation mode (NIRBS)” method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method.Methods: We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer.Results: A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1–35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation.ConclusionsNIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.