Multipolar traction with homemade “spider” device to improve submucosal dissection of gastric superficial lesions is safe and effective

Bordet, Martin; Lambin, Thomas; Wallenhorst, Timothée; Rivory, Jérôme; Jacques, Jérémie; Héroin, Lucile; Pioche, Mathieu

doi:10.1055/a-1682-6685

Cited by 3 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The technique has been recently improved by providing multiple traction points, using four rubber bands linked to a central rubber band, to get traction on the different edges of the lesion; this multipolar "spider" traction was applied in the stomach [67] and in the colon [68].…”

Section: Distal Attachment Capmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

Self Cite

View full text Add to dashboard Cite

ESGE suggests conventional endoscopic submucosal dissection (ESD; marking and mucosal incision followed by circumferential incision and stepwise submucosal dissection) for most esophageal and gastric lesions. ESGE suggests tunneling ESD for esophageal lesions involving more than two-thirds of the esophageal circumference. ESGE recommends the pocket-creation method for colorectal ESD, at least if traction devices are not used. The use of dedicated ESD knives with size adequate to the location/thickness of the gastrointestinal wall is recommended. It is suggested that isotonic saline or viscous solutions can be used for submucosal injection. ESGE recommends traction methods in esophageal and colorectal ESD and in selected gastric lesions. After gastric ESD, coagulation of visible vessels is recommended, and post-procedural high dose proton pump inhibitor (PPI) (or vonoprazan). ESGE recommends against routine closure of the ESD defect, except in duodenal ESD. ESGE recommends corticosteroids after resection of > 50 % of the esophageal circumference. The use of carbon dioxide when performing ESD is recommended. ESGE recommends against the performance of second-look endoscopy after ESD. ESGE recommends endoscopy/colonoscopy in the case of significant bleeding (hemodynamic instability, drop in hemoglobin > 2 g/dL, severe ongoing bleeding) to perform endoscopic hemostasis with thermal methods or clipping; hemostatic powders represent rescue therapies. ESGE recommends closure of immediate perforations with clips (through-the-scope or cap-mounted, depending on the size and shape of the perforation), as soon as possible but ideally after securing a good plane for further dissection.

show abstract

Section: Distal Attachment Capmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

Self Cite

View full text Add to dashboard Cite

show abstract

“…Multipolar traction is a recent advance in colorectal endoscopic submucosal dissection (ESD) to expose the submucosal field 1 particularly for challenging lesions like residual lesions 2 . Nevertheless, two limitations exist with four-point traction.…”

Section: Figmentioning

confidence: 99%

Endoscopic submucosal dissection of colonic residual laterally spreading tumor with adaptive traction: use of the additional loops to improve traction focally in difficult area

et al. 2022

Self Cite

View full text Add to dashboard Cite

“…One limitation of ESD is adequate encasement of the lesion during dissection due to contraction. A new proposed technique is the use of a ‘spider’ device that provides multipolar traction via four endoscopic clips that fixate to each pole of the lesion with countertraction via the opposing mucosal wall [32 ▪ ]. Another refinement to the ESD method involves the use of electrolyte-free gel immersion to preserve a clear visual field during intervention thus allowing for precise coagulation for haemostasis [33 ▪ ].…”

Section: Management: Emerging Endoscopic Therapeutic Modalitiesmentioning

confidence: 99%

Gastric submucosal mass lesions

Desai

Monsrud

Willingham

2022

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

Purpose of reviewGastric submucosal mass lesions are a collection of tumours that arise in the stomach and are deep to the mucosal layer. Distinct from gastric epithelial carcinomas, these tumours are generally more indolent. They are often found incidentally on upper endoscopy. Most often they present as smooth protuberant masses covered by normal intact gastric mucosa. The majority are asymptomatic. Endoscopic ultrasound (EUS) is frequently employed to further characterize the lesions. EUS can be diagnostic of some lesions, such as lipomas, and can be used to guide fine needle aspiration to diagnose others. Adding to the traditional management approaches of observation and surgical resection, numerous new and emerging endoscopic therapies are now being used to resect these gastric tumours.Recent findingsThis review focuses on evolving strategies in the diagnosis and management of submucosal mass lesions. Although surgical intervention was once the lone option for intervention, there are an increasing number of endoscopic therapies. There have also been advancements in neoadjuvant therapies and in distinguishing the malignant potential of submucosal mass lesions.SummaryGastric submucosal lesions are common. EUS is frequently indicated in the evaluation and diagnosis. For tumours for which observation is not recommended, novel endoscopic therapies may offer less invasive management options.

show abstract

Multipolar traction with homemade “spider” device to improve submucosal dissection of gastric superficial lesions is safe and effective

Cited by 3 publications

References 5 publications

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic submucosal dissection of colonic residual laterally spreading tumor with adaptive traction: use of the additional loops to improve traction focally in difficult area

Gastric submucosal mass lesions

Contact Info

Product

Resources

About