Digestive Diseases and Sciences

, Volume 64, Issue 10, pp 2955–2964 | Cite as

EndoClot®SIS Polysaccharide Injection as a Submucosal Fluid Cushion for Endoscopic Mucosal Therapies: Results of Ex Vivo and In Vivo Studies

  • Ming-Sen Dai
  • Ke-Wei Hu
  • Wei Wu
  • Guo-Jian Yin
  • Duan-Min HuEmail author
Original Article



There are many studies on submucosal injection materials, but their clinical use is restricted for various reasons. The objective of this study was to compare the feasibility and safety of injected EndoClot®SIS polysaccharide as a submucosal injection material (SFC) in ESD in the pig stomach to that of injected sigMAVisc™ or Eleview™.


Four pig stomachs were used for the ex vivo study. Eighteen pigs were used for the in vivo study. In the ex vivo study, four injections were made in the gastric submucosa to induce submucosal uplift and extend its duration. Tissue change was observed. The in vivo study was performed in 2 steps. First, 3 injections were made in the esophageal mucosa to induce submucosal uplift and extend its duration. Histological change was observed. Second, ESD was performed in the stomach by injecting EndoClot®SIS polysaccharide, sigMAVisc™, or Eleview™ (each, n = 6) as an SFC. The effects of these agents on wound healing were examined. We evaluated the efficacy and safety of endoscopic surgery after EndoClot®SIS polysaccharide injection.


EndoClot®SIS polysaccharide produced a longer-lasting elevation with clearer margins than was achieved by sigMAVisc™, Eleview™, or 0.9% NaCl and thereby enabled precise ESD without complications, such as bleeding and perforation. No obvious histopathological damage was observed at the injection site on endoscopy and histology.


Submucosally injected EndoClot®SIS polysaccharide increased the effective separation of the mucosa and submucosa and reduced surgical complications. Hence, EndoClot®SIS polysaccharide injection is a safe and effective submucosal injection material.


Submucosal injection Endoscopic submucosal dissection EUS Experiments on animals 



The authors are grateful to Suzhou AnDeJia Biotechnology Co., Ltd. for providing injection materials.

Author’s contribution

Ming-Sen Dai and Ke-Wei Hu designed the study; Guo-Jian Yin, Wei Wu, Duan-Min Hu performed the experiments; and Ming-Sen Dai analyzed the data and, and wrote the manuscript.


This study was supported by grants from the Jiangsu Province Young Medical Talents Program (No. 2016-2020) and the Health Bureau of Suzhou (Nos. SYZ201632 and SS201641).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Supplementary material

10620_2019_5686_MOESM1_ESM.docx (1.9 mb)
Supplementary material 1 (DOCX 1922 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ming-Sen Dai
    • 1
  • Ke-Wei Hu
    • 1
  • Wei Wu
    • 1
  • Guo-Jian Yin
    • 1
  • Duan-Min Hu
    • 1
    Email author
  1. 1.Department of GastroenterologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina

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