Endoscopic submucosal tunnel dissection with ring-thread countertraction for a large gastric tumor with extensive severe fibrosis

Successful Resection of a Gastric Tumor With Severe Fibrosis Using Endoscopic Submucosal Tunnel Dissection and a Picking Technique With a Clutch Cutter

“…Resections of gastric tumors with severe fibrosis by the endoscopic submucosal dissection (ESD) procedure are still difficult in some cases. 1 Endoscopic submucosal tunnel dissection has been reported to be a good method for providing traction, 2 , 3 and the usefulness of a picking technique with a clutch cutter (CC) for a protruding rectal tumor with the muscle-retracting sign has recently been reported. 4 We report successful resection of a gastric tumor with severe fibrosis using endoscopic submucosal tunnel dissection and a picking technique with a CC.…”

Successful resection of a 16-cm half-circumferential lesion at the greater curvature of the stomach using the endoscopic submucosal large-tunnel method

“…In terms of curative resection, there are few reports of ESD for giant lesions of > 15 cm. Various methods, such as traction, tunneling, or a combination method, have been devised but all are sometimes complicated 1 2 3 . By considering the order in which such lesions are resected, this large-tunnel method can be used to obtain reliable en bloc resection of giant lesions.…”