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.
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: Anthony Yuen Bun Teoh; Philip Wai Yan Chiu; So Fei Hon; Tony Wing Chung Mak; Enders Kwok Wai Ng; James Yun Wong Lau Journal: Surg Endosc Date: 2012-10-24 Impact factor: 4.584