New generation argon plasma coagulation in flexible endoscopy: Ex vivo study and clinical experience

Background and Aim: A new argon plasma coagulation (APC) system was developed to improve the conduction characteristics of existing systems and to achieve a true non‐contact procedure. We evaluated the new system in an ex vivo experiment and in two different clinical cases. Methods: Swine gastric walls were cauterized at various current settings and time intervals. The diameter and penetration depth of the cauterized areas were measured. We also describe the use of this method to treat patients with gastric hemorrhagic hereditary telangiectasias and a mucosal gastric cancer. Results: The ex vivo study revealed an improved maintenance of current conduction and greater control of the extent and penetration depth of the cauterization effects on tissue using the new APC system. In the clinical cases, hemorrhagic telangiectasias and an early stage gastric cancer were treated successfully without relapse using the new system. Conclusions: Improved current conduction and controllability of cauterization corresponding to emission time were demonstrated for the new APC. The new system allows expeditious superficial cauterization of a wide area without any contact with tissue. The therapeutic effect appeared favorable compared with previous APC devices for gastrointestinal applications.