2nd AERAT (Asan Medical Center EUS-guided Radiofrequency Ablation Training program)   2nd AERAT (Asan Medical Center EUS-guided Radiofrequency Ablation Training program) was held in Seoul, Korea from 6th to 7th January. Like last 1st AERAT training, many doctors participated in this time. A total of 12 doctors from HongKong, Malaysia, Singapore, India and Japan attedned and experienced various EUS related programs for 1night 2days. AERAT’s director Prof. Dong Wan, Seo gave a lecture related with EUS-procedure cases and his valuable experiences with attendees. Also, we prepared hands on session at Asan Meical Center Animal Laboratory with Phatom model. ex-vivo and procine model tests as well. All of attendees had their own experiences with our EUSRA probe. All the participants gave a good feedback that AERAT program was a satisfactory training course. We hope to meet many doctors in our RFA traiing class near in the future.        

World J Gastroenterol. 2016 Oct 28; 22(40): 9022–9027. Safety and efficacy of self-expandable metallic stents in malignant small bowel obstructions Akiyoshi Tsuboi, Toshio Kuwai, Tomoyuki Nishimura, Sumio Iio, Takeshi Mori, Hiroki Imagawa, Toshiki Yamaguchi, Atsushi Yamaguchi, Hirotaka Kouno, Hiroshi Kohno AbstractIn this report, we present 3 cases of malignant small bowel obstruction, treated with palliative care using endoscopic self-expandable metallic stent (SEMS) placement, with the aim to identify the safety and efficacy of this procedure. Baseline patient characteristics, procedure methods, procedure time, technical and clinical success rates, complications, and patient outcomes were obtained. All 3 patients had pancreatic cancer with small bowel strictures. One patient received the SEMS using colonoscopy, while the other 2 patients received SEMS placement via double balloon endoscopy using the through-the-overtube technique. The median procedure time was 104 min. The technical and clinical success rates were 100%. Post-treatment, obstructive symptoms in all patients improved, and a low-residue diet could be tolerated. All stents remained within the patients until their deaths. The median overall survival time (stent patency time) was 76 d. SEMS placement is safe and effective as a palliative treatment for malignant small bowel obstruction.KeywordsSelf-expandable metallic stents; Malignant small bowel obstructions; Endoscopy; Case report; Pancreatic cancer   Figure 1 Self-expandable metallic stent deployment using the standard through-the-scope technique under fluoroscopic guidance. A: The scope was advanced to the stricture, and a standard guidewire was passed through the stricture; B: The stent delivery system was advanced through the scope across the stricture; C: The stent can be seen successfully deployed across the stricture.

Endosc Ultrasound. 2016 Sep-Oct; 5(5): 320–327. A two-center comparative study of plastic and lumen-apposing large diameter self-expandable metallic stents in endoscopic ultrasound-guided drainage of pancreatic fluid collections Tiing Leong Ang, Pradermchai Kongkam,1 Andrew Boon Eu Kwek, Piyachai Orkoonsawat,1 Rungsun Rerknimitr,1 and Kwong Ming Fock Background and ObjectivesEndoscopic ultrasound-guided drainage of walled-off pancreatic fluid collections (PFCs) (pseudocyst [PC]; walled-off necrosis [WON]) utilizes double pigtail plastic stents (PS) and the newer large diameter fully covered self-expandable stents (FCSEMS) customized for PFC drainage. This study examined the impact of type of stent on clinical outcomes and costs.Patients and MethodsRetrospective two-center study. Outcome variables were technical and clinical success, need for repeat procedures, need for direct endoscopic necrosectomy (DEN), and procedure-related costs.ResultsA total of 49 (PC: 31, WON: 18) patients were analyzed. Initially, PS was used in 37 and FCSEMS in 12. Repeat transmural drainage was required in 14 (PS: 13 [9 treated with PS, 4 treated with FCSEMS]; FCSEMS: 1 [treated with PS]) due to stent migration (PS: 3; FCSEMS: 1) or inadequate drainage (PS: 10). Technical success was 100%. Initial clinical success was 64.9% (25/38) for PS versus 91.7% (11/12) for FCSEMS (P = 0.074). With repeat transmural stenting, final clinical success was achieved in 94.6% and 100%, respectively (P = 0.411). Compared to FCSEMS, PS was associated with greater need for repeat drainage (34.2% vs. 6.3%, P = 0.032). The need for and frequency of DEN was similar between both groups, but PS required more frequent balloon dilatation. PS was significantly cheaper for noninfected PC. Costs were similar for infected PC and WON.ConclusionPS was associated with a higher need for a second drainage procedure to achieve clinical success. The use of FCSEMS did not increase procedural costs for infected PC and WON.KeywordsEndosonography, endotherapy, necrosectomy, pancreatic necrosis, pseudocyst    Figure 3. Endoscopic image of Nagi™ stent inserted for drainage of infected walled-off necrosis

 Taewoong Medical Research Center has newly-organized a preclinical team to provide preclinical evaluation service for medical devices  ‘Build a foundation for systematic research to support R&D and provide histological analysis.’   Taewoong Medical has been continuously investing in product development since its foundation in 1999 and engaged in organic research cooperation with many research institutions at home and abroad, making efforts to diversify and improve the functionality of the product. This year in March, a preclinical team has been established in Taewoong Medical’s Osong research center.Preclinical Studies are executed to test a medical device in animals before conducting any clinical trials in the patient to verify biological safety and effectiveness of the medical device. Biocompatibility testing and risk assessment for marketing approval of medical devices necessarily entails accurate analysis of data from biological evaluation and animal testing. Therefore, the newly-organized preclinical team is attracting expectations to enhance the competitiveness of the product while improving the safety in medical procedures.The new preclinical team provides expert research support services to various medical personnel and researchers, not to mention supporting Taewoong’s own products in development. The team has already been entrusted with animal tissue with biomaterial implant from several universities and research institutions and has embarked on the histological analysis service.For those researchers who require animal experiments will benefit from a laboratory animal center of Osong Medical device development center (Department of evaluation Bio Compatibility assessment team; www.kiobhealth.kr). A researcher-centered ‘One-way system’ embracing from the whole process of animal testing to histological analysis will be introduced in the near future. In addition, to aid the safe and correct use of commercial products, the domestic and international sales divisions are preparing to implement training programs using experimental animals targeted for medical specialists.With the installation of the new preclinical team, Taewoong Medical can internally evaluate cell testing and animal testing from early stages of development to the point of completing a new product, which will enable Taewoong to introduce mature products to the market in a much shorter period of time. Also, offering targeted training programs to medical specialists and histological analysis service will enhance efficiency and research achievements of medical devices.

Preliminary report on a EUS guided pseudocyst drainage with a new lumen apposing metal stent (SPAXUS™); single center, 9 months experience   Background and AimsEndoscopic ultrasound (EUS)-guided drainage has become a mainstay for treating peripancreatic fluid collection and fully covered metal stent provided more efficient drainage than plastic stent. Recently, wide-flanged fully covered metal stent is introduced in EUS-guided pseudocyst drainage and showed promising results. The aim of this study was to evaluate the feasibility and efficacy of EUS-guided pseudocyst drainage with a new lumen apposing metal stent (Niti-S™ SPAXUS™ Stent; Taewoong Medical, Seoul, Korea).MethodA prospective, single-arm, multicenter feasibility study of EUS-guide pseudocyst drainage with SPAXUS™ is now enrolling patients at 6 tertiary hospital in Korea. This preliminary report describes single center, 9 months experiences of the multicenter study. Between January and September 2016, a total of 11 patients were treated with EUS-guided pseudocyst drainage with SPAXUS™ in our institute. Baseline characteristics and outcomes including technical/clinical success rate, adverse event, and recurrence rate were evaluated.ResultThe median age of 11 patients was 57 (42-76) and male was 10 of 11 patients. The median size of PFC was 80 mm (60-160 mm). SPAXUS™ was successfully placed all patients and PFC resolution was achieved in all 11 patients at median of 35 days after stent placement. The median procedure time was 7 min (5-10 min). Three cases of fever were developed during immediate post-procedure period and all of them were successfully treated with intravenous antibiotics. No other immediate post-procedure adverse events were seen. One case of stent occlusion was developed 40 days after procedure and endoscopic stent cleaning with retrieval balloon was conducted. Until now, no case of PFC recurrence was observed.ConclusionEUS-guided pseudocyst drainage with SPAXUS™ was conducted effectively and safely in our institute until now. Further multicenter experience would be helpful to clarify the role of this procedure.-----  

 [2016 상반기 우수특허 대상]태웅메디칼‘자가 팽창 스텐트’, 두 장기를 연결한국일보 : [2016 상반기 우수특허 대상] 태웅메디칼태웅메디칼(대표 신경민, www.stent.net)은 1991년 설립된 의료기기 제조 및 수출기업이다. 태웅메디칼은 약 60여개 국가에 연간 3,000만달러 이상의 수출을 하고 있으며 2014년 미국지사를 설립해 적극적인 해외투자에 나서고 있다. 특히 세계적으로 품질의 우수성을 인정받고 있는 스텐트(인체내강 확장용 의료기기)의 지속적인 제품 개발을 위해 많은 투자를 하고 있다.태웅메디칼이 이번에 개발한 ‘Niti-S SPAXUS 스텐트’는 형상기억합금인 나이티놀 와이어를 사용해 제작된 자가 팽창형 금속 스텐트이다. 두 장기를 연결할 수 있도록 스텐트의 양쪽 끝 단에 두 장기를 연결하고 고정할 수 있는 기술이 적용됐다.이 스텐트의 특징은 형상기억합금 와이어를 교차되게 엮어 제작한 몸통 부위와 날개 부위로 이뤄져 있으며 스텐트는 실리콘 피막으로 코팅돼 있다. 스텐트의 날개부위는 인접된 두 장기 사이에 밀착해 연결할 수 있으며, 몸통부위는 내경을 확보해 배수 및 이동경로 변경의 통로를 만들어준다.태웅메디칼은 소화기내과용 스텐트에 머무르지 않고 비뇨기과용, 뇌혈관, 약물방출 등의 스텐트를 지속적으로 개발할 계획이다.http://hankookilbo.com/v/e665b273a5c945efb86984caacdc9bcf

DDW 2016 (Digestive Disease Week), San Diego, USA  Taewoong Medical participated DDW 2016 with a huge attention of attendees in San Diego, USA. Exhibition booth consisted of SPAXUS™ Stent section, Endoscopic RFA area, Stent area and extended meeting rooms. Design concept was simple and modern, which emphasized full exposure of our company identity. Especially we prepared to demonstrate SPAXUS™ user friendly delivery system so that visitors could try easy deployment.   The day before DDW, Taewoong Medical organized partner’s day with global distributor at Holiday Inn, Bayside. We had SPAXUS Hands on class with special dummy model and a lively discussion time about EUSRA & ELRA, Endoscopic RFA products. In particular, Euromedical, Italy presented their sales strategy and current state of RFA business, and this invaluable sharing would stand partners in good stead when it comes to meeting customers. Mr. Shin, CEO, Taewoong Medical, expressed thanks to the all partners regarding their effort and cooperation in closing remark.   2nd day of DDW congress, the valued customers and friends from all of the world were invited to SeaWorld, attraction of San Diego. Taewoong Medical prepared special show with killer whales and dinner buffet beside the pool. All attendees seem to return to the innocence of childhood during the show, and they had a great time even though some of them were dripping wet by whales.Upcoming next DDW 2017 is going to be held at Chicago. Hope we can get together again!  

Website Renewal to become more easily to access even if you can access mobile device Have you visited our website lately?You can see optimize pages whichever way you look at it.  PC Screen Shot We have finished website renewal to become more easily to access and use even if you can access mobile device and also renewed the entire design and the structure of previous website in order to make easier to use and more convenience for obtaining necessary information with regard to our business activities and products for valuable customers and business partners through brand new website. We aim to proactively and effectively deliver updated valuable information regarding our business activities, products and services to customers and we also utilize our website as a part of sales and marketing tools for global users. As you know we have also opened Facebook webpage and we always aim to have a better communication with partners and customers! Please visit the updated TaeWoong Website and send us the sincere feedback! Mobile Screen Shot   Through recent update, following new pages and products been added into the website.Customer Service: You can find General product information which is frequently asked like MRI Information, Storage.Meet Us At: Find congress and TW event informationProduct:M Biliary StentEndoscopic Accessory OPTIMOS™

Ken Liu, Faculty of Medicine at the University of Sydney in Camperdown, New South Wales, Australia, reports on his Review Article“Fully covered self-expandable metal stents for treatment of benign biliary strictures.”   The focus of this paper was the use of fully covered self-expandable metal stents (FCSEMS) in the treatment of benign biliary strictures (BBSs). There has been an explosion of recent research on the use of FCSEMSs in BBSs with suggestions of a paradigm shift from using plastic stents. Due to their growing popularity, we felt it was important to review the available literature on the efficacy, safety, and cost-effectiveness of FCSEMSs in BBSs.FCSEMSs have been shown to achieve excellent success rates in both transplant and non-transplant BBSs (>90% in some studies). This success is sustained for over 12 months in most studies. The efficacy of FCSEMSs is unchanged when used as first-line or as second-line therapy (after balloon dilation and plastic stenting). The subset of patients with BBSs secondary to chronic pancreatitis remains a challenge (46-75% success). Results of FCSEMSs in BBSs are similar to studies of plastic stents, in particular, studies using multiple plastic stents. Fewer ERCP sessions are required for treatment of BBSs with FCSEMSs which may result in cost savings, although published data are lacking.   Figure 1. A, An example of the classic stent type (Bonastent; Standard Sci-Tech). B, An example of a new stent type (Niti-S Kaffes; Taewoong). The stent sits entirely within the biliary tree with a long removal string that rests in the duodenum. The antimigration feature in this stent is the gradual tapering in the middle of the stent FCSEMSs are safe to use. Adverse events such as pancreatitis, cholangitis, secondary strictures, and pain are infrequent and usually respond to conservative management. Spontaneous stent migration rates are variable; however, several anti-migration modifications have demonstrated efficacy in reducing this adverse event.There is still a need for further studies, in particular, randomized controlled trials comparing FCSEMSs vs. plastic stents. Data are also lacking regarding optimal duration of stent placement, and the cost effectiveness and long term safety of FCSEMSs.Read this article on pages 13-21 of the print Journal or find it online.The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

 한덕현 교수, 유럽서 요관스텐트 라이브수술 시연덴마크 코펜하겐 학회에서 유벤타 스텐트 주제로 시연 및 강의기사입력시간 : 2013-09-26 11:08:39최종편집시간 : 2013-09-26 11:08:39이혜선 기자    [청년의사 신문 이혜선]성균관의대 삼성서울병원 비뇨기과 한덕현 교수가 지난 3~7일 5일간 덴마크 코펜하겐에서 열린 EAU(유럽비뇨기과학회) 주관, 요로결석학회 및 수술 워크숍(2nd Meeting of the EAU Section of Urolithiasis(EULIS))에서 유벤타 스텐트(Uventa stent)라는 주제로 라이브수술 및 강의를 시행했다.3일 열린 수술 워크숍(surgical workshop)에서는 네 종류의 요관용 금속스텐트에 대한 강의 및 라이브 수술이 시연됐다.한덕현 교수는 라이브 수술자로 참석하여 새로 개발된 이중금속커버스텐트에 대한 논문(Efficacy and safety of a novel, double-layered, coated, self-expandable metallic mesh stent (Uventa™) in malignant ureteral obstructions) 및 임상경험을 소개했으며 악성종양으로 인한 요관폐색 환자에게 성공적으로 수술을 시연해 참가 의료진들로부터 주목을 받았다.한덕현 교수는 “요관협착은 타장기에 비해 금속스텐트의 적용이 늦게 시작된 분야로서, 기구의 발전과 임상경험의 축적이 절실한 상태”라며 “삼성서울병원에서는 이미 보편화된 수술 경험이, 이제 시작하는 유럽의 의사들에게는 많은 관심을 유발한 것 같다”고 소감을 밝혔다.EULIS는 유럽비뇨기과학회(EAU)에서 결석 및 비뇨내시경 관련 학술모임을 활성화하고자 만든 세부학회로 올해로 2회째를 맞고 있다. 금번 학회는 유럽의 요로결석 전문가 300여 명이 참석한 가운데 개최됐다.http://www.docdocdoc.co.kr/news/newsview.php?newscd=2013092600007

  Leading off the 2nd EULIS Meeting in Copenhagen was a special pre-conference symposium on metal stenting of the ureter on September 4th. This special event took place in the Copenhagen University Hospital, the Rigshospitalet, and featured live surgery demonstrations. Mr. Noor Buchholz was key in bringing together all four companies producing metal stents for the first time. “About two years ago, I had a vision for bringing together the four companies involved in the development and production of metal stents. As the EULIS Section meeting was approaching, we decided to piggy-back the stent workshop as a pre-meeting symposium,” Buchholz explained.“Metal stents are very much a niche market, so I think it’s more important for the companies to work together to spread awareness of these products, rather than compete for a small target audience. I’m trying to raise awareness of the use of metal stents in urology, because I think they are very useful for the “right” patients.”Mr. Buchholz points out two major problems of preconceptions about metal stenting. “We’ve seen metal stents in the past that simply didn’t work, so older urologists won’t touch them. The second problem is related: younger urologists aren’t being taught about them, and might not even be familiar with them.”According to Buchholz, this newer generation of stents, as developed in the past ten years has one key advantage over the older models: they are much easier to place and remove, which can be done through minimally invasive surgery. The biggest advantage compared to contemporary competitors like the double-J stent is their longevity:“The initial purchase price is considerably higher, but because the stents do not have to be replaced two or three times per year like plastic stents, the patient requires less surgery, making it cost-neutral in the first year. From the second year onward, it’s an annual saving of some €5000 per patient. And the patient won’t have to undergo regular surgery, with all of the disadvantages thereof. It’s a great solution for patients who need long-term stenting. One of my patients has had a stent for 80 months now.”The four companies involved in the symposium were PNN Medical with its Memokath thermolabile nitinol stent, Cook Medical with its grooved metal double-J Resonance stent, Allium with its self-expanding polyurethane stent, and Taewoong with its Uventa Ureteral Stent, another self-expanding stent. The live surgery demonstrations were given for each of the four companies’ stents.Other presentations at the symposium showed the current state of developments, techniques for placement and maintenance, as well as a look into the future of metal stents. Biocompatibility and biodegradability are two important properties for improved treatment of patients. Other innovations are the antibody-coated stents, nanotube coating and radioactive stents for internal treatment. An absorbable magnesium metal stent is to combine the inertness of biomaterial with the stability of a metal.