Endoscopic mucosal resection for middle and large colorectal polyps with a double-loop snare

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Endoscopic mucosal resection (EMR) is a key technique for removing colorectal polyps.
• Novel endoscopic devices are continuously developed to improve resection efficiency and outcomes.
• The Dualoop snare is a new double-loop snare designed for colorectal polyp EMR.

Purpose of the Study:

• To analyze the efficacy of the Dualoop snare for colorectal polyp resection.
• To compare the performance of the Dualoop snare against a standard round snare in EMR.
• To evaluate factors influencing en bloc resection success with the Dualoop snare.

Main Methods:

• A clinical trial was conducted across two Japanese referral centers.
• Snare firmness was experimentally analyzed using a pressure gauge.
• EMR outcomes (en bloc resection, complications) were compared between 589 polyps resected with Dualoop and 339 with a standard round snare.

Main Results:

• The Dualoop snare exhibited the highest firmness among tested snares.
• An overall en bloc resection rate of 95.4% was achieved with the Dualoop snare.
• Significantly higher en bloc resection rates were observed for 15-19 mm polyps using Dualoop (97.9%) compared to the round snare (80.0%).
• For large polyps (≥20 mm), the en bloc resection rate with Dualoop was 64.7%.

Conclusions:

• EMR using the Dualoop snare is effective for en bloc resection of mid-sized and large colorectal polyps.
• Factors like patient age, polyp size, and polyp morphology impact en bloc resection success.
• The Dualoop snare represents an advancement in EMR technology for colorectal polyp management.