Endoscopic submucosal dissection assisted by novel “clip fishing method” (with video)

Abstract

The "clip-fishing method" in use in vivo in an anesthetized pig. d UCTN -Unusual cases and technical notes E277Ueki M et al. Endoscopic submucosal dissection assisted by novel "clip fishing method" … Endoscopy 2010; 42: E277 -E278 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Traction method versus conventional endoscopic submucosal dissection for gastric epithelial neoplasms

“…Because maintaining an appropriate submucosal view is the key to safe and rapid ESD, maintaining the appropriate tension on the submucosa for dissection using an endoscope hood or gravity is needed. Various traction devices have been developed to visualize the submucosal layer during ESD, thereby overcoming these technical difficulties [9–16] …”

“…Various traction devices have been developed to visualize the submucosal layer during ESD, thereby overcoming these technical difficulties. [9][10][11][12][13][14][15][16] Ensuring the appropriate direction of traction, however, is important. For example, a recent multicenter RCT found that although procedure times did not differ significantly between patients who underwent the clip-with-line method and those who underwent conventional gastric ESD, the procedure times were shorter using the clip-with-line method for lesions located at the greater curvature of the upper and middle thirds of the stomach.…”

“…[7,8] Access to the submucosal layer during gastric ESD may be enhanced by various traction devices. [9][10][11][12][13][14][15][16] Although these devices have contributed to overcoming technical difficulties, the ability of traction to reduce procedure time remains unclear. For example, 1 report comparing conventional ESD with tractionassisted ESD using dental floss and hemoclips suggested that traction devices did not reduce procedure time in the total population, but significantly reduced procedure time for gastric neoplasms located in the greater curvature of the upper or middle third of the stomach, without increasing the rate of adverse events (AEs).…”

“…Access to the submucosal layer during gastric ESD may be enhanced by various traction devices [9–16] . Although these devices have contributed to overcoming technical difficulties, the ability of traction to reduce procedure time remains unclear.…”

Usefulness of the thread‐traction method in esophageal endoscopic submucosal dissection: Randomized controlled trial

“…As a result, an effective countertraction is obtained, ensuring and maintaining an improved field of view. Efficient dissection then becomes possible, [9][10][11][12][13][14][15] contributing to shortening of the treatment time.…”