VideoGIE| Volume 84, ISSUE 3, P537-538, September 2016

Download started.


Endoscopic submucosal dissection of a large colonic polyp with the use of novel electrosurgical scissors and traction with hemoclip and dental floss

Published:April 07, 2016DOI:
      Endoscopic submucosal dissection (ESD) allows curative en-bloc resection of early GI neoplasms. Conventional ESD for colonic tumors using knives is technically demanding with high perforation risks because of difficulty in controlling the depth of dissection and thin colonic wall. Moreover, lack of traction can make the procedure very time consuming, especially for large polyps. Clutch Cutter (Fujiflim, Japan) is a rotatable, grasping-type scissor forceps that can grasp and cut a piece of tissue precisely with an electrosurgical current. Traction using a hemoclip attached to dental floss allows good exposure of the submucosal plane to enhance dissection. In a patient with an 8 × 5-cm sigmoid lateral spreading tumor, granular type (Paris Is+IIa, Sano type II), we combined the use of a Clutch Cutter for mucosal incision and submucosal dissection and a hemoclip (HX610-135; Olympus, Japan) attached to dental floss as a traction method to facilitate the progress of ESD (Fig. 1, Video 1, available online at The time required to complete the procedure was 314 minutes (7.85 min/cm2), which is significantly shorter compared with ESD with conventional knives without any traction method in our center (39.2 min/cm2).
      Figure thumbnail gr1
      Figure 1En-bloc resection of large 8 × 5-cm sigmoid polyp with ESD using a Clutch Cutter and traction with a hemoclip and dental floss.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect