磁锚定技术辅助经尿道膀胱肿瘤内镜下黏膜剥离术的实验研究

目的:探讨磁锚定技术在辅助经尿道膀胱肿瘤内镜下黏膜剥离术中应用的可行性,以期为该技术的临床应用做前期探索。方法:自行设计加工磁锚定装置(包括锚定磁体和靶磁体),以离体猪膀胱为模型,经尿道进胃镜并注入气体适度膨胀膀胱,观察膀胱黏膜情况,设定病变部位后退出胃镜。经胃镜活检孔送入软组织夹,借助软组织夹和胃镜将靶磁体钳夹固定于待切除的膀胱黏膜边缘,膀胱外放置锚定磁体,移动锚定磁体即可改变靶磁体的牵拉方向和力量,辅助完成病变黏膜剥离切除。结果:在4个离体猪膀胱模型上成功切除了病灶处黏膜。结论:体外实验显示磁锚定装置可辅助经尿道膀胱肿瘤内镜下黏膜剥离切除,具有设计加工简单、操作灵活的优点,进一步优化设计后有临床应用潜力。

Experimental study on magnetic anchoring technique assisted endoscopic transurethral mucosal dissection of bladder tumor

Objective To explore the feasibility of magnetic anchoring technique in assisted endoscopic transurethral bladder tumor mucosal dissection,in order to facilitate its clinical application.Methods A self-designed and processed magnetic anchoring device was involved in the study along with the isolated pig bladder as the model,which was composed of an anchoring magnet and a target magnet.Through the urinary tract the gastroscope was placed into the bladder which was expanded after some gas was injected.The bladder mucosa was observed,and the gastroscope was withdrawn after setting the lesion.A soft tissue clamp was sent to the bladder through the biopsy hole,and the target magnet grasper was fixed to the bladder mucosa margin through the soft tissue clamp and gastroscope.The anchoring magnet was placed in vitro.The drawing direction and strength of the target magnet were changed by moving the anchoring magnet,so that the stripping resection of the affected mucosa could be completed successively.Results The mucosa of the focus was successfully removed on 4 isolated pig bladders.Conclusion In vitro experiments show that magnetic anchoring device can assist in endoscopic mucosal dissection of bladder tumor through urethra.It has the advantages of easy design,manufacture and operation,and can be used clinically after optimal design.