Double-tunnel circumferential endoscopic submucosal dissection with double clip-band-line traction for an esophageal squamous neoplasm

Abstract

Double-tunnel circumferential endoscopic submucosal dissection with double clipband-line traction for an esophageal squamous neoplasm ▶ Fig. 1 Schematic of the steps involved in the double-tunnel and double-traction method for resection of a large superficial esophageal lesion including: a a circumferential anal incision; b incision and creation of the first tunnel; c, d the second incision and tunnel created at the opposite end of the circumference; e the "clip band line" placed on the first pillar; f dissection of the first pillar; g the second "clip band line" on the second pillar and dissection of the second pillar; h the completed circumferential endoscopic submucosal dissection. Fraile-López Miguel, Parra-Blanco Adolfo. Double-tunnel, double-traction ESD with the clip-band-line method … Endoscopy UK Video 1 Double-tunnel and double-traction method applied on both pillars for circumferential esophageal endoscopic submucosal dissection. ▶ Fig. 2 Endoscopic views during the double-tunnel and double-traction endoscopic submucosal dissection showing: a the esophageal lesion with Lugol stain; b the circumferential anal cut; c the first tunnel; d the second tunnel; e dissection of the first pillar with the use of clip-band-line traction; f dissection of the second pillar with a second "clip band line" applied; g the circumferential scar. h Macroscopic appearance of the resected specimen. Fraile-López Miguel, Parra-Blanco Adolfo. Double-tunnel, double-traction ESD with the clip-band-line method … Endoscopy E-VideosThis document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Circumferential endoscopic submucosal dissection for long-segment Barrettʼs adenocarcinoma: the double-tunnel and single clip-and-loop traction method

“…Circumferential endoscopic submucosal dissection (ESD) is an organ-preserving procedure for large areas of esophageal neoplasia. Currently, various endoscopic techniques have been described 1 2 3 4 . Here, we report a successful circumferential ESD of long-segment Barrett’s esophagus (C10M12) using the double-tunnel and single clip-and-loop traction method.…”

“…Circumferential endoscopic submucosal dissection (ESD) is an organ-preserving procedure for large areas of esophageal neoplasia. Currently, various endoscopic techniques have been described [1][2][3][4].…”

Snare-based circumferential traction technique for endoscopic submucosal dissection of long circumferential early esophageal carcinoma

“…Although tunneling dissection is reported to be effective in facilitating endoscopic submucosal dissection (ESD) of esophageal circumferential lesions 1 2 3 , endoscopists may lose visualization inside the narrow tunnel and it can be challenging to dissect the ridges between the tunnels 4 5 . Herein, we propose a snare-based circumferential traction technique to improve the long circumferential ESD of early esophageal cancer ( Video 1 ).…”

Wide-tunnel endoscopic submucosal dissection with clip-and-line traction for large circumferential esophageal neoplasm

“…However, it remains technically challenging and time-consuming for circumferential lesions [2]. The strategies reported for circumferential diseases have operational complexity [2,3]. Herein, we present an ESD method involving a single, wide tunnel and clip-and-line traction for resection of a large circumferential esophageal neoplasm.…”

“…Endoscopic submucosal dissection (ESD) has become the main method for management of superficial esophageal lesions [1]. However, it remains technically challenging and time-consuming for circumferential lesions [2]. The strategies reported for circumferential diseases have operational complexity [2,3].…”