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. 2022 Aug 20;7(10):353-357.
doi: 10.1016/j.vgie.2022.07.002. eCollection 2022 Oct.

Novel articulating through-the-scope traction device

Cem Simsek  1 , Christopher C Thompson  1 , Khaled J Alkhateeb  2 , Sebastian A Jofre  2 , Hiroyuki Aihara  1
Affiliations

Novel articulating through-the-scope traction device

Cem Simsek et al. VideoGIE. .

Abstract

Video 1Parts and functions of the novel articulating traction device with its application in gastric and colonic endoscopic submucosal dissection procedures.

Keywords: ESD, endoscopic submucosal dissection.

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Figures

Figure 1
Figure 1
Overview of the traction device. A, Device consists of 2 parts, hand controller and distal articulating arm and jaw, which are connected by a cable. B, Distal arm has an articulating and rotatable grasper. C, The device is inserted through the 3.7-mm instrument channel, and the hand controller is mounted on the biopsy port.
Figure 2
Figure 2
Movements of the articulating arm and rotatable grasper: gripping and rotation of the grasper, flexion, rotation, and advancement of the articulating arm.
Figure 3
Figure 3
Summary of the first case. A, A 10-mm Paris IIa lesion in the antrum. B, A traction device was introduced after marking, submucosal injection, and mucosal incision steps. C, The mucosal flap was grasped by the jaws, and dissection was started with a scissor knife. D and E, Excellent exposure was obtained with dynamic modification of traction with flexion-extension and rotation movements. F, Final defect after completion of dissection.
Figure 3
Figure 3
Summary of the first case. A, A 10-mm Paris IIa lesion in the antrum. B, A traction device was introduced after marking, submucosal injection, and mucosal incision steps. C, The mucosal flap was grasped by the jaws, and dissection was started with a scissor knife. D and E, Excellent exposure was obtained with dynamic modification of traction with flexion-extension and rotation movements. F, Final defect after completion of dissection.
Figure 4
Figure 4
Summary of the second case. A, A 5-cm, laterally spreading granular tumor lesion in the rectosigmoid colon. B, The traction device was introduced after completion of the mucosal incision. C, Dissection was started from the distal end using a scissor knife. D, The lesion was regrasped at a different area of the mucosal flap to obtain better exposure. With increased traction force, tenting of the muscle deserves attention to prevent injury. E, Dynamic modification of traction with flexion-extension and rotation movements. F, A second regrasping maneuver from the proximal side. G, Specimen measuring 5 × 4 cm.
See this image and copyright information in PMC

References

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