Tips for and Pitfalls in Colorectal ESD Using a Flex Knife Naohisa Yahagi 1 , Daisuke Kikuchi 1 , Takafumi Ohtsuka 1 , Syu Hoteiya 1 , Toshiro Iizuka 1 , Hideo Mizuno 1 , Mitsuyo Hashimoto 1 1Department of Gastroenterology, Toranomon Hospital, Tokyo Keyword: 大腸ESD , フレックスナイフ , 大腸腫瘍 pp.1085-1090
Published Date 2007/6/25
DOI https://doi.org/10.11477/mf.1403101134
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 Endoscopic submucosal dissection(ESD)has become popular practice in Japan, and many endoscopists are trying to resect large and difficult lesions using this technique, even if they are colonic lesions. ESD is a wonderful technique, enabling us to resect a whole lesion in an en-bloc fashion, but it involves higher risks of complications.

 Good positioning and maneuverability of the endoscope are essential for a safe and reliable ESD procedure. The flex knife is the most suitable device for colorectal ESD, since it is easy to control due to its soft and flexible nature and also the knife length is adjustable according to the circumstances. We usually carry out mucosal incision and submucosal dissection after giving rise to sufficient submucosal protrusion and keeping the knife length to approximately1~2mm. It is quite a safe procedure if we can get good vision of the operating field and good maneuverability of the endoscope.

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