Endoscopic submucosal dissection of large colorectal tumors by using a novel spring-action S-O clip for traction (with video)

Gastrointest Endosc. 2009 Jun;69(7):1370-4. doi: 10.1016/j.gie.2008.12.245. Epub 2009 Apr 28.

Abstract

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.

Design: Case series.

Setting: Juntendo University Hospital.

Main outcome measurements: 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.

Limitation: Uncontrolled study.

Conclusion: 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.

MeSH terms

  • Aged
  • Colon / surgery
  • Colonoscopy / methods*
  • Colorectal Neoplasms / surgery*
  • Dissection
  • Female
  • Humans
  • Intestinal Mucosa / surgery
  • Male
  • Middle Aged
  • Surgical Instruments
  • Traction / instrumentation*
  • Treatment Outcome
  • Video Recording