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Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia

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A novel device for endoscopic submucosal dissection, the Fork knife.

Hyun-Gun Kim¹, Joo-Young Cho, Gene-Hyun Bok

¹Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, College of Medicine, SoonChunHyang University, 657 Hannam-Dong, Yongsan-Gu, Seoul 140-743, South Korea.

World Journal of Gastroenterology

|November 27, 2008

Summary

The novel Fork knife (Endo FS) device demonstrates effective endoscopic submucosal dissection (ESD) for gastric lesions. This tool achieved high en bloc and complete resection rates while significantly reducing procedure time compared to the Flexknife.

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Published on: April 28, 2026

Area of Science:

Gastroenterology
Endoscopic Surgery
Surgical Innovation

Background:

Endoscopic submucosal dissection (ESD) is a minimally invasive technique for gastric lesion resection.
Novel instruments are continuously developed to improve ESD efficacy and safety.

Purpose of the Study:

To evaluate the efficacy and technical aspects of the Fork knife for ESD.
To compare the Fork knife with the Flexknife in gastric lesion resection.

Main Methods:

Retrospective comparison of 265 gastric lesions treated with Fork knife (group A) and 72 with Flexknife (group B).
Analysis of tumor characteristics, pathological findings, resection rates, complications, and procedure times.

Main Results:

Similar specimen sizes and en bloc resection rates (95.8% vs 93.1%) between groups.
Higher complete resection rates (81.1% vs 73.6%) and lower perforation rates (0.8% vs 1.4%) for the Fork knife.
Significantly reduced mean procedure time for the Fork knife (59.63 min vs 76.65 min, P < 0.05).

Conclusions:

The Fork knife is a valuable tool for clinical ESD practice.
The Fork knife offers an advantage in reducing endoscopic submucosal dissection procedure time.