“…22 Another technique uses electrosurgical dissection with the T-type hybrid knife (ERBE, Tübingen, Germany), an ESD knife that allows injection of saline solution through the tip of the knife, obviating the need for repeated accessory exchanges between needle injector and knife that are needed with the triangular-tip knife. 44 An alternative technique, possibly more accessible to those with modest ESD experience, uses a through-the-scope dilation balloon such as a short-nosed biliary extraction balloon or a longer esophageal dilation balloon (CRE; Boston Scientific, Natick, Mass) to dissect the submucosal tunnel without electrosurgery. 9,23 The group at Zhongshan Hospital, Shanghai, compared the T-type hybrid knife and triangular tip knife in a head-to-head, prospective, randomized study of 100 patients, which revealed shorter procedure time, lower bleeding rate, and less frequent use of coagulation forceps to control bleeding with the T-type hybrid knife.…”