Post written by Fumisato Sasaki, MD, PhD, from Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

The pocket-creation method (PCM) has been reported as a useful method in endoscopic submucosal dissection (ESD).

On the other hand, the spring-and-loop with clip (S-O clip; Zeon Medical, Tokyo, Japan) is a useful traction device for ESD. This report is about ESD using a combination of the PCM and S-O clip that was useful for a case of early gastric cancer with severe ulcer scarring.

The submucosal layer of the scar was severely fibrotic, making it difficult to identify the submucosal and muscular layers. However, the dissection layer could be clearly identified using the PCM. After creating a full circumferential incision, we could maintain a clear view of the dissecting layer by using an S-O clip.

By using a combination of the PCM and S-O clip, even difficult cases could be safely treated with basic endoscopic techniques.

The spring-and-loop with clip (S-O clip; ZEON Medical, Tokyo, Japan).

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.