2018 Volume 93 Issue 1 Pages 52-56
Hybrid endoscopic submucosal dissection (H-ESD) is an endoscopic mucosal resection technique that uses a snare after circumferential incision and partial submucosal dissection. This procedure shortens the procedure time but increases the risk of piecemeal resection owing to snare resection. Although acceptable for endoscopic treatment of colorectal tumors, it is not commonly used to treat gastric tumors. The endoscopic knife specifically designed for H-ESD combines a needle-type tip and a snare within a single device. This device is available in Japan, and we recently performed H-ESD for a gastric tumor using this device. Indications of H-ESD for gastric tumors used at our hospital are: 1) tumor size <10mm, 2) absence of ulcerative findings, 3) cT1a stage disease and, 4) differentiated tumors based on histopathological examination. We report the indications, devices, and technical details of H-ESD for gastric tumors.
