Abstract Purpose In rectal cancer endoscopic surgery, the tissue hangs down and obstructs the surgical field when using a scalpel to make an incision to expose the tumor. Thus, there is a need for a tissue elimination device because the surgical field can be secured by lifting the hanging tissue during this surgery. Methods We developed a wire-driven film-type device for tissue elimination that can be driven even in limited spaces such as the spatial constraints in the rectum. The device is composed of a polyethylene terephthalate film and stainless steel with a belt-loop structure to reduce film swelling. The belt-loop prevents film swelling and facilitates device movement without restriction of the obstacles above it. In addition, the device generates a force exceeding 1 N at a displacement of 0–10 mm. We used a mechanical model to analyze the relationship between the force at the device tip and the tensile force acting at the belt-loop position. This analysis facilitated the optimization of the belt-loop position. Results A maximum force of 4.25 N was achieved at a tensile force of 40 N under the specified displacement conditions. Further, the device with the optimized belt-loop position achieved a maximum force of 10.3 N at a tensile force of 40 N, which was approximately 2.4 times higher than that of the device before optimization. Conclusion The wire-driven film-type device for tissue elimination can optimize the belt-loop position to satisfy the required specifications. Furthermore, evaluation results of the devices indicate it possesses sufficient performance for use in rectal cancer endoscopic surgery.
Kuruma et al. (Mon,) studied this question.