Endoscopy 2007; 39(6): 566-569
DOI: 10.1055/s-2007-966394
Case report

© Georg Thieme Verlag KG Stuttgart · New York

Grasping-forceps-assisted endoscopic submucosal dissection using a novel irrigation cap-knife for large superficial early gastric cancer

K.  Kume1 , M.  Yamasaki1 , I.  Yoshikawa1 , M.  Otsuki1
  • 1Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan
Further Information

Publication History

submitted 7 September 2006

accepted after revision 12 December 2006

Publication Date:
06 June 2007 (online)

The technique of endoscopic submucosal dissection (ESD) needs special skills and involves a long procedure. We therefore developed a new type of dissection knife, the irrigation cap-knife (the Kume cap-knife attachment, which uses a fixed snare), that facilitates ESD by just sliding over the muscle layer with a coagulating current. The ESD procedure using the irrigation cap-knife was performed in seven patients with intramucosal gastric cancer. The tumor was separated from the surrounding normal mucosa using the insulated-tip knife. Submucosal dissection was then performed by pushing our device along the muscle layer while applying a coagulating current, at the same time as a grasping forceps, deployed through the accessory channel, was used to push the lesion away from the muscle layer. The rate of en bloc resection was 100 % (7/7). The irrigating cap-knife was extremely useful for ESD of large intramucosal cancers in the stomach.

References

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K. Kume, MD, PhD 

Department of Gastroenterology and Metabolism

University of Occupational and Environmental Health, Japan

School of Medicine

1-1, Iseigaoka

Yahatanishi-ku

Kitakyushu 807-8555

Japan

Fax: +81-93-6920107

Email: k-kume@med.uoeh-u.ac.jp