CLIP WITH RUBBER BAND MODIFICATION FOR DYNAMIC TRACTION IN COLONIC ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD)

63-year-old-woman referred to ESD due to 40-mm-laterally-spreading-tumor, nongranular, Paris 0-Is+IIa, JNET-type-2B, consistent with residual lesion from previous resection, with tattoo adjacent, in the descending colon. Partial mucosal incision was done. Inadequate submucosal layer exposure was noted despite pocket-creation method and underwater strategy. After complete circumferential incision, a clip grasping a rubber-band with 3nylon rings (handmade with fishing line)attached, was applied to the lesion. One nylon ring was grasped, secured to the opposite wall, and then cut with a loop cutter after ESD. Another clip grasping a remaining ring was applied in a different location in the colonic wall, readjusting traction.

Publication History

Article published online:
14 April 2022