PROPOSAL OF DOUBLE-POINT TRACTION: DENTAL FLOSS CLIP TRACTION-ASSISTED ESD METHOD FOR GREATER CURVATURE OF THE MIDDLE UPPER STOMACH

Abstract

ESD has garnered significant interest among endoscopists and has rapidly gained global recognition. This technique was conceptualized and developed in the late 1990s, overcoming initial challenges through the dedication and expertise of our esteemed JGES members. Domestic insurance approval was first achieved in 2006 for gastric ESD, expanded to esophageal ESD in 2008, and to colorectal ESD in 2012. The key to a smart and successful ESD is effective countertraction. Optimal countertraction creates appropriate tension in the tissue, allowing for pinpointing and speedy incision and dissection. This technique not only facilitates a bloodless ESD but also reduces the risk of perforation. In recent years, various traction devices have emerged on the market, providing endoscopists with an expanded range of options to enhance their procedures. Dental floss clip traction-assisted ESD (DFC-ESD) is an inexpensive and simple technique, that is widely practiced in hospitals. A randomized controlled trial suggested that DFC-ESD provides a remarkable reduction in procedure time, especially for lesions in the mid-upper greater curvature of the gastric body. This study introduces the double-point traction method as an efficient and safe method for obtaining DFC-ESD countertraction.