Post written by Georgios Mavrogenis, MD, from the Third Space Endoscopy Unit, Mediterraneo Hospital, Athens, Greece.

Resection of submucosal tumors by means of endoscopic submucosal dissection (ESD) or submucosal tunneling endoscopic resection (STER) is associated with several technical challenges. In particular, access to the tumor base is often limited because of firm attachment to the muscularis propria.

Unlike ESD for mucosal lesions, effective countertraction during ESD or STER for subepithelial tumors such as GI stromal tumors or leiomyomas is difficult to achieve, as the hard tumor surface cannot be reliably grasped using conventional endoscopic clips. Moreover, the concept of countertraction during STER has yet to be systematically implemented.

In this video article, we present an innovative traction strategy using a novel anchor-probed clip deployed directly onto the tumor surface functioning as a “hook.” This configuration enables effective and stable countertraction through either a clip-and-line or clip-and-band system. By providing controlled exposure of the tumor’s base, this technique facilitates safer and more precise dissection. We believe that this approach represents a meaningful advancement in endoscopic resection of GI stromal tumors and leiomyomas using endosurgical techniques.

From the article video: Leiomyoma of the gastroesophageal junction removed by clip-assisted submucosal tunnelling endoscopic resection.

Read the full article online.

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