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Updated: Jun 5, 2026
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The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Endoscopic submucosal dissection for colorectal neoplasia
Kiyoaki Honma1, Makoto Kobayashi, Hidetaka Watanabe
1Department of Therapeutic Endoscopy, Nihonkai General Hospital, Yamagata, Japan.
Summary
Endoscopic submucosal dissection (ESD) for colorectal neoplasia is now safer and easier with the novel stag beetle knife (SBK). This new device facilitates effective en-bloc resection with negative margins in all patients.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Medical Devices
Background:
- Endoscopic submucosal dissection (ESD) is established for early gastric cancer but underutilized in colorectal procedures due to technical challenges.
- The complexity of colorectal anatomy presents unique difficulties for standard ESD techniques.
Purpose of the Study:
- To evaluate the efficacy and safety of a newly developed scissors-type device, the stag beetle knife (SBK), for colon ESD.
- To determine if the SBK can improve the ease and safety of performing ESD in the colorectum.
Main Methods:
- A novel scissors-type device, the stag beetle knife (SBK), was developed to enhance safety and ease of colon ESD.
- The SBK was used to perform ESD in 25 patients diagnosed with colorectal neoplasia.
Main Results:
- ESD procedures using the SBK were successfully completed in all 25 patients with colorectal neoplasia.
- The SBK enabled safe and easy lesion treatment without unintended incisions, delayed hemorrhage, or perforation.
- En-bloc resection with negative margins was achieved in every case.
Conclusions:
- Endoscopic submucosal dissection (ESD) using the stag beetle knife (SBK) offers a safer and more manageable approach for colorectal neoplasia.
- The SBK demonstrates significant potential to overcome the technical barriers previously limiting ESD in the colorectum.
