Korean J Gastrointest Endosc.  2008 Jun;36(6):341-348.

Traction with using a Rubber Band and Clips for Effective Endoscopic Submucosal Dissection

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Incheon, Korea. colochoi@korea.com
  • 2Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Incheon, Korea.

Abstract

BACKGROUND/AIMS: Traction with using a rubber band and clips may be helpful for performing endoscopic submucosal dissection (ESD) by keeping adequate tissue tension and satisfactory submucosal exposure.
METHODS
17 patients with noninvasive neoplasias or intramucosal cancers (16 gastric lesions and 1 colonic lesion) were included to evaluate this technique's feasibility (3), because of a difficult location for dissection (11), unsatisfactory mucosal elevation despite adequate submucosal injection (2), and a high risk of perforation from the thin colonic wall (1). Submucosal dissection was performed after traction was applied, with a using a rubber band and clips, to a precut margin of the lesion.
RESULTS
The mean sizes of the 16 gastric neoplasias and the corresponding resected specimens were 16+/-9 mm (6~40) and 37+/-9 mm (18~50), respectively, and the sizes of the colonic intramucosal cancers and the resected specimens were 41 mm and 51 mm), respectively. Both the en-bloc resection rate and the complete resection rate were 77%. Complete ESD without snaring was preformed in 10 cases (59%). The traction was assessed as useful in eleven cases (65%), not useful in two (12%), and annoying in four (23%).
CONCLUSIONS
Traction with using a rubber band and clips can be useful for performing ESD.

Keyword

Endoscopic submucosal dissection; Traction; Complication; Gastric neoplasms; Colorectal neoplasms
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