If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
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 www.giejournal.org). 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 1En-bloc resection of large 8 × 5-cm sigmoid polyp with ESD using a Clutch Cutter and
traction with a hemoclip and dental floss.
