Endoscopic submucosal dissection of large colorectal tumors by using a novel spring-action S-O clip for traction (with video).
BACKGROUND
Endoscopic submucosal dissection (ESD) allows en bloc resection of large GI neoplasms, regardless of their size; however, technical difficulties associated with ESD in the colorectum make it less widely applied in the treatment of tumors in this region. To address this difficulty, we designed a rubber strip-based traction device, called the S-O clip (Sakamoto-Osada clip) and reported previously that ESD with this device was effective for complete resection of large, superficial colorectal neoplasms. In this report, we describe a novel spring-action version of the S-O clip (spring S-O clip) that improves the facility of clip use during ESD of colorectal tumors.


OBJECTIVE
To evaluate the efficacy and safety of the spring S-O clip for ESD of colorectal neoplasms.


METHODS
Case series.


METHODS
Juntendo University Hospital.


METHODS
The efficacy and safety of the spring S-O clip traction device during ESD of colorectal tumors.


RESULTS
In 3 cases, a large, superficial neoplasm in the right side of the colon was removed safely and successfully en bloc without complication. Procedure times for the 3 cases were 44, 27, and 49 minutes, with resected specimens measuring 40, 24, and 35 mm, respectively.


CONCLUSIONS
Uncontrolled study.


CONCLUSIONS
This limited case series demonstrates that spring S-O clip-assisted ESD is safe and effective for en bloc resection of large superficial neoplasms in the right side of the colon.
Sakamoto
Naoto
N
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. sakamoto@juntendo.ac.jp
Osada
Taro
T
Shibuya
Tomoyoshi
T
Beppu
Kazuko
K
Matsumoto
Kenshi
K
Mori
Hiroki
H
Kawabe
Masato
M
Nagahara
Akihito
A
Otaka
Michiro
M
Ogihara
Tatsuo
T
Watanabe
Sumio
S
D000368:Aged; D003106:Colon / Q000601:surgery; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D004210:Dissection; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D014143:Traction / Q000295:instrumentation*; D016896:Treatment Outcome; D014741:Video Recording