Multiloop as a novel traction method in accelerating colorectal endoscopic submucosal dissection.

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Traction methods are known to accelerate endoscopic submucosal dissection (ESD).
• The multiloop (M-loop) method was investigated as a traction technique for colorectal ESD.

Purpose of the Study:

• To evaluate the impact of the M-loop traction method on submucosal dissection time (SDT) and speed (SDS) in colorectal ESD.
• To assess the effectiveness of the M-loop method in assisting colorectal ESD procedures.

Main Methods:

• The M-loop method was applied to colorectal ESD procedures in 50 patients between January and August 2018.
• Procedures were performed by two experts and eight non-experts at a tertiary endoscopic center in Japan.
• Submucosal dissection time (SDT) and speed (SDS) were recorded.

Main Results:

• The mean SDT was 42.1 ± 4.16 minutes, and the mean SDS was 28.0 ± 2.89 mm²/minutes.
• Experts achieved a mean SDS of 38.9 ± 6.9 mm²/minutes, while non-experts achieved 25.3 ± 3.1 mm²/minutes.
• En bloc resection was successful in 100% of cases, with 3 adverse events reported.

Conclusions:

• The M-loop traction method demonstrated an improvement in SDS for colorectal ESD.
• The M-loop method is a potentially effective tool for assisting colorectal ESD.
• Further comparative studies are needed to validate the M-loop method against conventional ESD techniques.