Volume 3, Issue 11, Pages (November 2018)

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Presentation transcript:

Volume 3, Issue 11, Pages 358-360 (November 2018) Pulley traction-assisted colonic endoscopic submucosal dissection affords good visibility of submucosal layer Satoki Shichijo, MD, Kenshi Matsuno, MD, Yoji Takeuchi, MD, Noriya Uedo, MD, Ryu Ishihara, MD VideoGIE Volume 3, Issue 11, Pages 358-360 (November 2018) DOI: 10.1016/j.vgie.2018.08.007 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Colonscopic view showing a laterally spreading tumor in the ascending colon. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Colonscopic view showing involvement of the polyp with a diverticulum. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 During traction-assisted endoscopic submucosal dissection, creating a flap was difficult because of interference from the anal fold of the colon. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 The addition of another clip to the bottom of the cecum to create a “pulley.” VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Achievement of considerably better visibility of the submucosal layer. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 En bloc resection of the tumor in 29 minutes. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 7 Mucosal defect present after endoscopic submucosal dissection. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 8 Small muscle defect at the location of the diverticulum in the mucosal defect. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 9 Complete closure of the entire mucosal defect with clips. VideoGIE 2018 3, 358-360DOI: (10.1016/j.vgie.2018.08.007) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions