A Novel and Effective Delivery Method for Polyglycolic Acid Sheets to Post-endoscopic Submucosal Dissection Ulcers

 Shielding methods for post-endoscopic submucosal dissection (ESD) ulcers have delivery-related problems. We developed an enveloped device for this purpose and evaluated its usefulness.  Polyglycolic acid (PGA) sheets were delivered to six 3.0-cm ulcers in two resected porcine stomachs and six 5.0-cm ulcers in another three stomachs. In the regular method group, small PGA sheets were delivered via forceps. In the novel method group, a large PGA sheet was delivered via the new device. The methods were compared in terms of time, and macroscopic and histological findings of the ulcer floor.  The median time required to cover a 3.0-cm ulcer was 0.39 min/cm in the novel method group and 1.03 min/cm in the regular method group ( = 0.03), and to cover a 5.0-cm ulcer was 0.38 min/cm and 0.85 min/cm, respectively ( = 0.03). In the novel method group, the PGA sheets were in close contact, fully covering the ulcer floor. In the regular method group, the sheets were partly elevated from the ulcer floor.  This novel technique seems promising in this preliminary study.