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Related Experiment Video

Updated: May 15, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
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The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

Published on: February 13, 2026

Counter traction makes endoscopic submucosal dissection easier.

Tsuneo Oyama1

  • 1Department of Gastroenterology, Saku Central Hospital, Nagano, Japan.

Clinical Endoscopy
|December 20, 2012
PubMed
Summary

Improving counter traction techniques enhances endoscopic submucosal dissection (ESD) safety and efficiency. Simple methods like position change and the clip-line technique create better visualization for complex gastrointestinal procedures.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Endoscopic Procedures

Background:

  • Endoscopic submucosal dissection (ESD) is technically challenging due to poor counter traction and limited field of vision.
  • Effective counter traction is crucial for improving the speed and safety of ESD procedures.

Purpose of the Study:

  • To review and introduce various methods for achieving adequate counter traction during ESD.
  • To highlight simple and effective techniques that enhance visualization and procedural efficiency.

Main Methods:

  • Discussion of position change utilizing gravity for improved field of vision, particularly in esophageal and colon ESD.
  • Detailed explanation of the clip-with-line method for generating counter traction and clear visualization.
  • Introduction of alternative traction methods including external grasping forceps, internal traction, double-channel scopes, and double scopes.
Keywords:
CounterattractionEndoscopic submucosal dissectionStomach neoplasmsSurgical instruments

Related Experiment Videos

Last Updated: May 15, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
04:09

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

Published on: February 13, 2026

Main Results:

  • Position change is identified as the simplest method to improve vision, especially for esophageal and colon ESD.
  • The clip-with-line method effectively provides both counter traction and a clear field of vision, enhancing ESD efficiency and safety.
  • Various other traction methods are presented as options for different clinical scenarios.

Conclusions:

  • Implementing effective counter traction strategies significantly simplifies and improves the safety of endoscopic submucosal dissection.
  • The clip-with-line method offers a practical and efficient solution for achieving necessary counter traction in ESD.