Diving, lifting, and horizontal dissection followed by loop-clip traction (DLH+T) can facilitate mucosal flap creation during colorectal ESD

Endoscopic Submucosal Dissection of Superficial Colorectal Neoplasms at “Challenging Sites” Using a Double-Balloon Endoluminal Interventional Platform: A Single-Center Study

“…Furthermore, the creation of a TZ associated with the availability of traction to the lesion allows a better visualization of the cutting plane and a reduction in the insufflation of CO 2 or, in the case of an underwater technique, of the volume of liquid. Our results showed high technical success with the new version of the device (DiLumen EZ-Glide) consistent with prior data reported in the literature (92-100%) [11][12][13][14][15][16]. This result is promising, and it could change the ESD technique, making this platform and consequently ESD accessible to everyone without the need for a particularly steep learning curve.…”

“…A double-balloon endoluminal interventional platform (EIP) (DiLumen™, Lumendi LLC, Westport, CT, USA) was introduced to help aid in the stabilization of the endoscope during endoscopic interventions in the colon (Figure 1). Furthermore, the device provides the ability to create a therapeutic zone (TZ) with the possibility of dynamic traction generated through the use of suture loops [11][12][13][14][15][16]. In this study, we evaluated our initial experience with the platform comparing the outcomes of EIP with the standard cap-assisted ESD (S-ESD) at "challenging sites".…”

Exploring the landscape of colorectal endoscopic submucosal dissection in Taiwan: In‐depth investigation of complication risks

“…6 By employing this standardized approach, dissection speed can be enhanced, potentially reducing the likelihood of complications, particularly in cases associated with submucosal fibrosis resulting from prior biopsies. 6 With conventional traction methods sometimes falling short, Chou et al introduced a novel double endoscopy ESD with snare traction. 7 The retrospective study showed a median procedure time of 32.45 min for double-scope ESD, significantly shorter than the 54.61 min for matched conventional ESD.…”

“…First, Chang et al have developed the Diving, Lifting, and Horizontal dissection technique with the loop–clip traction method, which streamlines mucosal trimming and facilitates the creation of mucosal flaps, ultimately increasing surgical efficiency 6 . By employing this standardized approach, dissection speed can be enhanced, potentially reducing the likelihood of complications, particularly in cases associated with submucosal fibrosis resulting from prior biopsies 6 . With conventional traction methods sometimes falling short, Chou et al introduced a novel double endoscopy ESD with snare traction 7 .…”