Patients and Methods
The purpose of this prospective single center clinical trial was to evaluate the feasibility of MAG-ESD for large early gastric cancer in humans. The technique had previously been reported as successful in a porcine model.
Twenty-five patients, median age 70 years, with early gastric cancer measuring >20 mm located in the gastric body (stomach) were seen on an inpatient basis for an ESD at the National Cancer Center Hospital in Tokyo. The final aim was to achieve an en bloc resection (removal of the entire cancerous growth).
The MAG system is composed of both internal and external components. The intracorporeal magnetic anchor consists of a hand-made stainless steel magnetic weight of six grams, and microforceps connected by a short thread. The magnetic anchor is delivered into the stomach of the patient through a hollow tube that incorporates the endoscope and the magnetic weight.
The extracorporeal magnetic control system includes a 35 cm extracorporeal magnet whose movement is controlled by the up-down motion of the external magnet itself as well as a movable examination table. The mobile examination table enabled control of the internal magnetic anchor so as to achieve ideal mucosal lifting to allow for the gastric submucosal dissection.