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DOI: 10.1055/a-1834-1776
A new traction device (S-O clip) facilitating the endoscopic submucosal dissection of tumors in the ileocecal valve region
Eine neue Traktionsvorrichtung (S-O-Clip) zur Erleichterung der endoskopischen Submukosa-Dissektion von Tumoren im Bereich der Ileozökalklappe
Abstract
Background Endoscopic submucosal dissection (ESD) is a method that can be used for en bloc resection, regardless of the size and form of the lesion. The special location of ileocecal tumors leads to insufficient counter-traction and poor field of vision, making ESD difficult. An S-O clip has been developed to simplify the attachment procedure, eliminating interference with the endoscope and improving accessibility.
Case presentation The patient was a 70-year-old man who presented with abdominal pain and bloating. A colonoscopy revealed a flat-elevated-type lesion on the ileocecal valve, with the oral side of the lesion having progressed to the terminal ileum. The traction direction was adjusted from distal to proximal during the procedure using the S-O clip. Finally, with the help of the S-O clip, the tumor was safely removed and collected.
Conclusion The S-O clip was successful in ESD of a colorectal tumor. By removing and re-anchoring the loaded ring, the S-O clips allowed the adjustment of traction direction from distal to proximal during ESD.
Zusammenfassung
Hintergrund Die endoskopische Submukosa-Dissektion (ESD) ist eine Methode, die für die En-bloc-Resektion verwendet werden kann, unabhängig von der Größe und Form der Läsion. Die besondere Lage von ileozökalen Tumoren führt zu unzureichender Gegentraktion und schlechtem Sichtfeld, was eine ESD erschwert. Ein S-O-Clip wurde entwickelt, um den Befestigungsvorgang zu vereinfachen, Interferenzen mit dem Endoskop zu vermeiden und die Zugänglichkeit zu verbessern.
Fallvorstellung Ein 70-jähriger männlicher Patient stellte sich mit Bauchschmerzen und Blähungen vor. Eine Koloskopie zeigte eine flach erhöhte Läsion an der Ileozökalklappe, wobei die orale Seite der Läsion zum terminalen Ileum fortgeschritten war. Die Traktionsrichtung wurde während des Eingriffs mit dem S-O-Clip von distal auf proximal eingestellt. Schließlich wurde der Tumor mithilfe des S-O-Clips sicher entfernt und entnommen.
Fazit Das Einsetzen des S-O-Clips war bei einer ESD eines kolorektalen Tumors erfolgreich. Durch das Entfernen und erneute Verankern des geladenen Rings ermöglichte der S-O-Clip die Anpassung der Traktionsrichtung von distal zu proximal während der ESD.
Publication History
Received: 10 March 2022
Accepted after revision: 17 April 2022
Article published online:
15 July 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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