A novel method of endoscopic mucosal resection using sodium hyaluronate

Background: Saline-assisted endoscopic mucosal resection is an established therapeutic method. However, it is sometimes difficult to maintain a desired level of tissue elevation after injection of saline. Therefore we decided to use a mucinous substance such as sodium hyaluronate instead of saline. Methods: Two resected porcine stomachs and five dogs were used for the study. The elevations, made by submucosal injections of sodium hyaluronate, were compared with those produced with normal saline. Sodium hyaluronate–assisted mucosal resections were compared with the saline-assisted resections. Results: Mucosal elevations created by submucosal injections of sodium hyaluronate remained for a longer time with a clearer margin compared to those made by saline injection. Endoscopic mucosal resections were performed safely with the assistance of sodium hyaluronate. Conclusions: Use of sodium hyaluronate instead of saline for endoscopic mucosal resection could make the procedure easier and more reliable.