Endoscopic submucosal resection with adaptative traction device: a new strategy to facilitate resection in patient with inflammatory bowel disease

Masgnaux, Louis-Jean; Pioche, Mathieu; Rivory, Jérôme; Rostain, Florian; Jacques, Jérémie; Fumery, Mathurin; Yzet, Clara

doi:10.1055/a-2020-9774

Cited by 3 publications

(4 citation statements)

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“…In preliminary studies, ATRACT ESD also showed a good R0 rate of 93% and a good safety profile [56]. In addition, the high traction provided by this device means that dissection indications can be extended to technically difficult lesions [57‒62], exposing even the thinnest submucosal layers, as in appendicular lesions [63], diverticular lesions [64], on an anterior resection site [59, 65, 66], or in the duodenum or the ileocecal valve. The high traction force also enables the endoscopist to be as close as possible to the muscle, in cases where a deep R0 resection is essential, such as T1 rectal lesions or neuroendocrine tumor [67] whatever the technique chosen between ESD and endoscopic intermuscular dissection [68].…”

Section: Endoscopic Submucosal Dissectionmentioning

confidence: 99%

Technical Advances in Endoscopic Resection Techniques for Lower GI Malignancies

Masgnaux,

Grimaldi,

Jacques

et al. 2024

Visc Med

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Background: The management of bulky neoplastic lesions in the digestive tract has historically been a surgical pursuit. With advancements in endoscopic techniques, particularly endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), a paradigm shift toward organ preservation has been initiated. These endoscopic methods, developed incrementally since the 1980s, have progressively enabled curative management of lesions with minimal morbidity, challenging the previously unchallenged domain of surgery. Summary: This review traces the evolution of endoscopic resection from snare polypectomy and EMR to sophisticated ESD, highlighting the technological innovations that have expanded the scope of endoscopic resection. It discusses the intricacies of various EMR techniques like underwater EMR, anchoring EMR, and hybrid EMR, alongside traction-assisted methods and the use of viscous solutions for submucosal injection. Additionally, the manuscript delves into the advancements in ESD, emphasizing traction strategies, knife technology, and the optimization of endoscopes. The benefits of these advancements are weighed against the challenges in anatomopathological interpretation posed by piecemeal resections. Key Messages: The continuous amelioration of endoscopic resection techniques has significantly improved the outcomes of digestive tract lesion management, particularly in achieving R0 resections and reducing recurrence rates. These advancements represent a monumental step toward minimizing the invasiveness of lesion management. However, despite the progress, the necessity for early follow-up post-EMR remains due to the non-negligible recurrence rates, underscoring the need for a rigorous postoperative surveillance regimen. Furthermore, our review suggests that while ESD has transformed the therapeutic landscape, its widespread adoption hinges on further simplification, safety enhancement, and acceleration of the procedure, possibly through innovations like adaptive traction devices.

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Section: Endoscopic Submucosal Dissectionmentioning

confidence: 99%

Technical Advances in Endoscopic Resection Techniques for Lower GI Malignancies

Masgnaux,

Grimaldi,

Jacques

et al. 2024

Visc Med

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“…We previously described the benefits of using adaptive traction devices (A-TRACT 2 and A-TRACT 4) to anchor two or four points of the lesion 4 5 . Here, we present the use and benefits of a specially designed adaptive traction device (A-TRACT 8) for multitraction via eight points in a giant rectal lesion in UC.…”

Section: Endoscopy E-videosmentioning

confidence: 99%

“…Several devices and techniques have been described to facilitate and speed up the procedure [1], and traction strategies have been increasingly implemented to improve the efficiency of dissection [3]. We previously described the benefits of using adaptive traction devices (A-TRACT 2 and A-TRACT 4) to anchor two or four points of the lesion [4,5]. Here, we present the use and benefits of a specially designed adaptive traction device (A-TRACT 8) for multitraction via eight points in a giant rectal lesion in UC.…”

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confidence: 99%

Multipolar traction with an eight-point adaptive traction device allowed comfortable resection of a challenging giant rectal lesion in ulcerative colitis

De Cristofaro,

Rivory,

Masgnaux

et al. 2023

Endoscopy

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“…It is designed to be pulled for resection with a traction mechanism. Additionally, a traction strategy using adaptive traction (ATRACT) devices has already been described as being particularly useful in complex lesions [3][4][5]. We report the case of 58-year-old patient with UC and a flat neoplastic lesion, 2 cm in size, in the sigmoid colon.…”

mentioning

confidence: 99%

Usefulness of a combination of an adaptive traction device and an insulated-type knife for a neoplastic lesion in ulcerative colitis

De Cristofaro,

Rivory,

Masgnaux

et al. 2024

Endoscopy

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Endoscopic submucosal resection with adaptative traction device: a new strategy to facilitate resection in patient with inflammatory bowel disease

Cited by 3 publications

References 0 publications

Technical Advances in Endoscopic Resection Techniques for Lower GI Malignancies

Technical Advances in Endoscopic Resection Techniques for Lower GI Malignancies

Multipolar traction with an eight-point adaptive traction device allowed comfortable resection of a challenging giant rectal lesion in ulcerative colitis

Usefulness of a combination of an adaptive traction device and an insulated-type knife for a neoplastic lesion in ulcerative colitis

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