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Endoscopic Mucosal Resection Using a Hooking Knife (Hooking EMR) Tsuneo Oyama 1 , Yuichi Kikuchi 2 , Shigeki Shimaya 1 , Akihisa Tomori 1 , Kin-ichi Hotta 1 1Department of Gastroenterology, Saku Central Hospital 2Department of Endoscopy, Saku Central Hospital Keyword: 内視鏡的粘膜切除術 , Hookingナイフ , ー括切除 pp.1155-1161
Published Date 2002/8/25
DOI https://doi.org/10.11477/mf.1403104523
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 Lymph nodal metastasis of gastric mucosal cancer is very rare, so, endoscopic mucosal resection (EMR) was selected for the treatment of such lesions instead of gastrectomy. However, the size of endoscopically resected specimens was 10~20 mm, so piece-meal resection was performed for larger lesions. Histological examination for the piecemeal-resected specimens was difficult compared with that of en-bloc resected specimens, so we developed a new EMR method, Hooking EMR, to resect larger en-bloc specimens.

 Firstly, we placed marks around the lesion using a coagulation needle. next, glycerol-diluted epinephrine solution was injected into the submucosal layer to separate the mucosal lesion from the proper muscular layer. Then, we cut the mucosa using a needle knife. Finally, we cut the submucosal fibers using a hooking knife and resected the lesion without using a snare.

 A large en-bloc resection, 70 mm or over in size, was possible with this new method. Because of this, the histological examination for both the range of lateral spreading and depth of invasion can be made more precisely. Hooking EMR is a new useful EMR method for resection of large lesions which until now, have required piece-meal resection.


Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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