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

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.

• Authors: Naoto Sakamoto, Taro Osada, Tomoyoshi Shibuya, Kazuko Beppu, Kenshi Matsumoto, Hiroki Mori, Masato Kawabe, Akihito Nagahara, Michiro Otaka, Tatsuo Ogihara, Sumio Watanabe
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 69 Issue 7 Pg. 1370-4 (Jun 2009) ISSN: 1097-6779 [Electronic] United States
• PMID: 19403131 (Publication Type: Journal Article)

Topics

• 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