AWC®duo reduces ESD time and facilitates safe resections

AWC®duo significantly reduces dissection time in ESD procedures and proves to be a safe and practical tool for facilitating resections in both upper and lower GI tract, as shown in ex vivo and first clinical data

Key findings

• Significantly shorter dissection time with AWC®duo vs. standard cap-assisted ESD in ex vivo model (17 min vs. 21 min, p<0.05)
• 95% R0 resection rate (21/22) in clinical cases with 100% en-bloc resection
• No perforations or significant bleeding complications in patient cohort
• AWC®duo rated as useful or very useful in 100% of clinical cases (36% useful, 64% very useful)
• AWC®duo actively used for 34% of resection time ex vivo and 37% in patients
• Particularly beneficial for challenging cases with difficult lifting, submucosal fibrosis, and for ESD beginners

Study details

• Prospective ex vivo study:
  n=15 AWC®duo ESD vs. n=15 standard cap-assisted ESD
• Retrospective clinical evaluation:
  n=22 patients who underwent AWC®duo assisted ESD (April–June 2025)
• Patients: neoplastic/preneoplastic lesions ≥20 mm
  (median size 44.5 mm, range 25–80 mm)
• Localization of lesions in upper/lower GI tract:
  esophagus n=2, stomach n=1, colon n=15, rectum n=4
• Aim: Investigation of resection speed, safety, and feasibility of AWC®duo in ESD procedures

Kunsch S, Ammer-Herrmenau C, Nedjahi A, Knoop RF, Ellenrieder V, Amanzada A, Neesse A. Endoscopic submucosal dissection with a novel cap-assisted additional working channel (AWC duo) increases resection speed: a pilot study. Frontline Gastroenterol. 2025. doi:10.1136/flgastro-2025-103325