Endoscopic submucosal dissection in the colon with adaptive traction device: resection strategy and device setup

Pioche, Mathieu; Masgnaux, Louis-Jean; Rivory, Jérôme; Ponchon, Thierry; Wallenhorst, Timothée; Legros, Romain; Jacques, Jérémie

doi:10.1055/a-1959-2010

Cited by 9 publications

(9 citation statements)

References 3 publications

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“…The multipolar ("spider") system described above is enhanced by the addition of a loop that may be tightened. As the force exerted by the central rubber band decreases as dissection progresses, the loop is tightened thus maintaining the traction force [70][71][72][73].…”

Section: Distal Attachment Capmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

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ESGE suggests conventional endoscopic submucosal dissection (ESD; marking and mucosal incision followed by circumferential incision and stepwise submucosal dissection) for most esophageal and gastric lesions. ESGE suggests tunneling ESD for esophageal lesions involving more than two-thirds of the esophageal circumference. ESGE recommends the pocket-creation method for colorectal ESD, at least if traction devices are not used. The use of dedicated ESD knives with size adequate to the location/thickness of the gastrointestinal wall is recommended. It is suggested that isotonic saline or viscous solutions can be used for submucosal injection. ESGE recommends traction methods in esophageal and colorectal ESD and in selected gastric lesions. After gastric ESD, coagulation of visible vessels is recommended, and post-procedural high dose proton pump inhibitor (PPI) (or vonoprazan). ESGE recommends against routine closure of the ESD defect, except in duodenal ESD. ESGE recommends corticosteroids after resection of > 50 % of the esophageal circumference. The use of carbon dioxide when performing ESD is recommended. ESGE recommends against the performance of second-look endoscopy after ESD. ESGE recommends endoscopy/colonoscopy in the case of significant bleeding (hemodynamic instability, drop in hemoglobin > 2 g/dL, severe ongoing bleeding) to perform endoscopic hemostasis with thermal methods or clipping; hemostatic powders represent rescue therapies. ESGE recommends closure of immediate perforations with clips (through-the-scope or cap-mounted, depending on the size and shape of the perforation), as soon as possible but ideally after securing a good plane for further dissection.

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Section: Distal Attachment Capmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

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“…We have developed an intensity-modulated multitraction device 3 4 5 , the A-TRACT 2 + 2 ( Fig. 1 ), which seems very promising for ileo-cecal valve lesions because it allows good exposure of the ileal part of the lesion.…”

Section: Figmentioning

confidence: 99%

Endoscopic submucosal dissection of a quasi-circumferential lesion of the ileo-cecal valve by using a novel adjustable traction device

et al. 2023

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“…This lesion invaded the anal verge. An adaptive traction device (A-TRACT 2 + 2, Hospices Civils de Lyon) was used to improve exposure of the area 2 3 4 following the current strategy of setup 5 . After circumferential incision, the first two loops were placed at the oral and anal edges of the target area ( Video 1 ), and initial dissection and trimming were done using only the auto-traction on these two sides.…”

Section: Figmentioning

confidence: 99%

Endoscopic resection using adaptive traction for a large recurrence after a full-thickness transanal endoscopic microsurgery: improving exposure is a key point for complete removal

et al. 2023

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Endoscopic submucosal dissection in the colon with adaptive traction device: resection strategy and device setup

Cited by 9 publications

References 3 publications

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic submucosal dissection of a quasi-circumferential lesion of the ileo-cecal valve by using a novel adjustable traction device

Endoscopic resection using adaptive traction for a large recurrence after a full-thickness transanal endoscopic microsurgery: improving exposure is a key point for complete removal

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