Endoscopic submucosal dissection for gastric neoplasms by using a novel attachment device—a one-sided, expandable balloon

Usefulness of a multibending endoscope in gastric endoscopic submucosal dissection

“…When dissection is performed from a distance, the blood vessels and the boundaries of the submucosal and muscle layers cannot be visually distinguished; this increases the risk of bleeding or perforation. Previous studies have reported a 1-sided expandable balloon 4 for use in gastric ESD and a multibending endoscope 5 for use in gastric EMR. It is particularly difficult to approach the lesser curvature of the stomach, the anterior wall of the gastric body, the fundus, and the angulus of the stomach.…”

“Floating” method and “lifting up” method: novel techniques of gastric endoscopic submucosal dissection for treating difficult-to-approach lesions

“…Endoscopic submucosal dissection (ESD) of lesions located on the lesser curvature of the gastric body is challenging because of the difficulty in approaching the lesion [1]. Although using a multibending endoscope or a special attachment device is a good solution in such a situation [2,3], these devices are often unavailable except in specialty institutions because of their limited applications and relatively high cost. Here, we present novel techniques using an attachment balloon usually used in endoscopic injection sclerotherapy (EIS) (▶ Video 1; ▶ Fig.…”