Post written by Satoshi Ono, MD, PhD, from the Department of Gastroenterology, Chiba-Nishi General Hospital, Matsudo, Chiba, Department of Gastroenterology, Tokyo Metropolitan Geriatric Medical Center, and Department of Gastroenterology, The University of Tokyo Hospital, Tokyo, Japan.

Nowadays, endoscopic resection has been accepted as a reliable choice for gastrointestinal neoplasms. Many endoscopists perform endoscopic resections, including endoscopic submucosal dissection (ESD), for large lesions all over the world.

However, larger lesions require a longer procedural time. As a result, they have to extend the fragile and large specimen carefully to not damage it in an exhausted condition after the long procedural time.

In this article, we demonstrated the gauze extension method (GEM) as a simple and easy way to extend the specimens obtained by endoscopic resection of gastrointestinal neoplasms. In short, extend the specimen’s mucosal side down on the sheet of dry gauze and then turn it over on the fixing board before the removal of the gauze. It is an effective and quick method, even for large specimens obtained by ESD.

In addition, this economical method requires only a sheet of dry gauze and some water droplets. Any other chemicals and devices are not necessary.

Another advantage of this method is the improvement of specimen’s condition for histopathological assessment. This method enables us to arrange the lateral edges easily by using forceps after the removal of the gauze.

Furthermore, the gauze removes mucus and residue from the surface of the specimen, facilitating macroscopic examination and discernment of the pathologically important areas of the specimen without damage. Using this method, the indeterminate lateral margins because of inappropriate processing of specimens could be reduced.

We believe that this GEM will emancipate not only the endoscopists but also the pathologists from the hard labor of processing and evaluating resected specimens.

Removing the gauze by countertraction using forceps.

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