Related Experiment Video
Updated: May 22, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Efficacy of novel SB knife Jr examined in a multicenter study on colorectal endoscopic submucosal dissection
Kiyoaki Homma1, Yuzo Otaki, Masaki Sugawara
1Department of Therapeutic Endoscopy, Nihonkai General Hospital, Yamagata, Japan. kf-homma@estate.ocn.ne.jp
Background And Aim:
Secure manipulation of forceps in endoscopic submucosal dissection (ESD) for colorectal tumors is sometimes hindered by the characteristics of that organ. SB knife Jr, which are scissor forceps using a mono-pole high frequency, were developed to avoid the difficulty of ESD operation in the colorectum. The aim of the present study was to examine the effectiveness of the SB knife Jr in colorectal ESD in 11 hospitals, mostly in northeastern Japan.
Materials:
One hundred and two colorectal tumors (49 non-granular laterally spreading tumor [LST] lesions, 39 granular LST lesions and 14 other lesions) that were resected by ESD operations using SB knife Jr between October 2009 and March 2010.
Results:
All tumors (102/102) were resected en bloc and could be observed in detail. The mean size of the resected pieces was 40.3 mm. The mean operation time was 54.2 min. Of the complications, one case of micro-perforation occurred during the manipulation of submucosal dissection, and this case was treated with clips in that operation. The rates of resection carried out only with SB knife Jr were 74.5% (76/102).
Conclusion:
The novel ESD using SB knife Jr in the colorectum offers a breakthrough in resection techniques for not only expert endoscopists but also general endoscopists.
Insights
The SB knife Jr facilitates colorectal endoscopic submucosal dissection (ESD), improving resection rates for various tumors. This novel tool enhances ESD techniques for both expert and general endoscopists.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Colorectal endoscopic submucosal dissection (ESD) can be challenging due to organ-specific characteristics.
- The SB knife Jr, a novel scissor forceps utilizing mono-pole high frequency, was developed to address these difficulties.
- Previous limitations in colorectal ESD necessitate innovative instrumentation.
Purpose of the Study:
- To evaluate the effectiveness of the SB knife Jr in performing colorectal ESD.
- To assess the feasibility and outcomes of using the SB knife Jr across multiple institutions.
- To determine the impact of this new device on colorectal tumor resection.
Main Methods:
- A multicenter study involving 11 hospitals, primarily in northeastern Japan.
- Analysis of 102 colorectal tumors (49 non-granular laterally spreading tumors [LST], 39 granular LST, and 14 other lesions) resected using the SB knife Jr between October 2009 and March 2010.
- Data collection on resection success, operative time, and complications.
Main Results:
- All 102 tumors were successfully resected en bloc with detailed observation possible.
- The mean size of resected specimens was 40.3 mm, with a mean operation time of 54.2 minutes.
- Resection solely with the SB knife Jr was achieved in 74.5% (76/102) of cases; one micro-perforation occurred and was managed with clips.
Conclusions:
- The SB knife Jr represents a breakthrough in colorectal ESD techniques.
- This device offers significant advantages for both expert and general endoscopists performing colorectal resections.
- The study demonstrates the SB knife Jr's efficacy and safety in a real-world clinical setting.
