title: Development and clinical usability of a new traction device "medical ring" for endoscopic submucosal dissection of early gastric cancer.
abstract: BACKGROUND
  Although various traction devices exist for endoscopic submucosal dissection (ESD), the effects of the material used in the devices on the human body has not been considered. Moreover, there has been no report on a device that facilitates dissection both on the oral and anal side of the lesion. We made a traction device that has no deleterious effects on the body and is noninvasive, easy to use, and enables a bilateral approach in ESD. We report the process of its creation and a prospective evaluation of its usage in actual ESD procedures.
  
  
  METHODS
  This study is prospective case control study. Thirty-seven patients for whom the device would be used were consecutively and prospectively enrolled (device used group). Control subjects in whom the device would not be used and who had lesions matched for size and location with those of the device used group were randomly selected (device not used group). Both groups were classified into three subgroups according to treatment difficulty: group A: easy; group B: intermediate; and group C: difficult. The dissection time per cm(2) in each group was examined.
  
  
  RESULTS
  Dissection times in the device not used group/device used group were as follows: group A, 5.8/2.1 min/cm(2) (p < 0.01); group B, 6.1/3.8 min/cm(2) (p < 0.05); and group C, 7.9/3.6 min/cm(2) (p < 0.01), respectively.
  
  
  CONCLUSIONS
  The newly developed medical ring was shown to be feasible and safe and allowed excellent visualization through suitable tension and facilitated rapid gastric ESD.
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. kmatumo@juntendo.ac.jp
authors.forename: Kenshi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Hiroya
authors.initials: H
authors.lastname: Ueyama
authors.forename: Hironori
authors.initials: H
authors.lastname: Konuma
authors.forename: Takasi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Takuo
authors.initials: T
authors.lastname: Hayashi
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Naoto
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ogihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Yao
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004210:Dissection / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery; D005773:Gastroscopy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome