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Background: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficulty. Thus, a noninvasive tool that facilitates the direct visualization of the submucosal layer is needed. Methods: Traction-assisted dissection was performed on 4 superficial lesions. The system consisted of a metallic clip attached by a nylon line to a sinker 6 × 4 × 4 mm in size and weighing 1 g. After partially dissecting the submucosa, the clip was attached to the edge of the exfoliated mucosa and the weight of the sinker pulled down the partly resected lesion. Observations: In all 4 cases, the sinker allowed direct visualization of the cutting line, and en bloc resection was successfully accomplished. Conclusions: These preliminary results suggest that sinker-assisted ESD is effective for the complete removal of selected superficial early colorectal cancer.
Background: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficulty. Thus, a noninvasive tool that facilitates the direct visualization of the The system consisted of a metallic clip attached by a nylon line to a sinker 6 × 4 × 4 mm in size and weighing 1 g. After partially dissecting the submucosa, the clip was attached to the edge of the exfoliated mucosa and the weight of the sinker pulled down the partly resected lesion. Observations: In all 4 cases, the sinker allowed direct visualization of the cutting line, and en bloc resection was successfully accomplished Conclusions: These preliminary results suggest that sinker-assisted ESD is effective for the complete removal of selected superficial early colorectal cancer.