ATH-06 First clinical experience with speedboat Rs2, a new multimodality device for colonic submucosal dissection

Introduction The ‘Speedboat-RS2’ (Creo-Medical/Wales/UK) is the first multi-modality device, incorporating bipolar-radiofrequency energy for cutting, microwave energy for coagulation, an integrated needle for submucosal injection, and a rotatable blade with a heat insulated hull. Methods A prospective database from June 2018 to Jan 2019 was analyzed including 20 consecutive patients (mean age: 69.7±15.18 years, 50% males) with 20 colorectal Lateral Spreading Tumours/LSTs. Two operators performed all colonic endoscopic submucosal dissections/ESDs. Results Sixteen procedures were performed under conscious sedation and 4 general anaesthesia (Olympus/CF-HQ290ZL/13.2 mm tip diameter). Median lesion size was 4 cm (range 1–9 cm). The LSTs and procedural characteristics are described in table 1. 1/20 case was abandoned during dissection. Endoscopically en-bloc resection was achieved in 11/19 (57.8%) cases and 10/19 cases (52.6%) resections were R0 histologically. In 8/19 patients snare excision was used to facilitate resection with a median of 2 resection pieces. Microwave energy was utilized to pre-coagulate and control active bleeding successfully in 17/19 (89.5%) cases and haemostatic monopolar forceps was required in 2 cases. Histology showed dysplasia in 15/19, NET in 1/19 and T1 cancer in 3/19. 2/3 patients with T1 cancers had endoscopic surveillance with no recurrence and 1 had surgery and no residual tissue. 3/19 patients experienced delayed bleeding all requiring endoscopic hemostasis. No perforation was seen. Conclusions This early experience with SRS2 shows colorectal submucosal dissections are feasible with an acceptable safety profile. Resection times for lesions ≤4 cm were relatively quick and microwave coagulation appeared to be effective in most cases.