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. 2018 Sep 25;3(11):358-360.
doi: 10.1016/j.vgie.2018.08.007. eCollection 2018 Nov.

Pulley traction-assisted colonic endoscopic submucosal dissection affords good visibility of submucosal layer

Satoki Shichijo  1 , Kenshi Matsuno  1 , Yoji Takeuchi  1 , Noriya Uedo  1 , Ryu Ishihara  1
Affiliations

Pulley traction-assisted colonic endoscopic submucosal dissection affords good visibility of submucosal layer

Satoki Shichijo et al. VideoGIE. .
No abstract available

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Figures

Figure 1
Figure 1
Colonscopic view showing a laterally spreading tumor in the ascending colon.
Figure 2
Figure 2
Colonscopic view showing involvement of the polyp with a diverticulum.
Figure 3
Figure 3
During traction-assisted endoscopic submucosal dissection, creating a flap was difficult because of interference from the anal fold of the colon.
Figure 4
Figure 4
The addition of another clip to the bottom of the cecum to create a “pulley.”
Figure 5
Figure 5
Achievement of considerably better visibility of the submucosal layer.
Figure 6
Figure 6
En bloc resection of the tumor in 29 minutes.
Figure 7
Figure 7
Mucosal defect present after endoscopic submucosal dissection.
Figure 8
Figure 8
Small muscle defect at the location of the diverticulum in the mucosal defect.
Figure 9
Figure 9
Complete closure of the entire mucosal defect with clips.
See this image and copyright information in PMC

References

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    1. Shichijo S., Yamasaki Y., Takeuchi Y. Case of colonic adenoma involving a diverticulum resected by a traction-assisted endoscopic submucosal dissection technique. Dig Endosc. 2017;29:729–730. - PubMed
    1. Li C.H., Chen P.J., Chu H.C. Endoscopic submucosal dissection with the pulley method for early-stage gastric cancer (with video) Gastrointest Endosc. 2011;73:163–167. - PubMed
    1. Oyama T. Counter traction makes endoscopic submucosal dissection easier. Clin Endosc. 2012;45:375–378. - PMC - PubMed
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