Related Experiment Video
Updated: May 23, 2026
Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
Published on: March 3, 2023
Comparative effectiveness of the Clutch Cutter versus Dual knife for esophageal endoscopic submucosal dissection by
Kei Terasaki1, Kyoko Sakai2, Yoshimichi Yorioka3
1Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, 1-2 Kawazono-cho, Suita, Osaka, 564-0013, Japan. t-kei@koto.kpu-m.ac.jp.
Background:
A Clutch Cutter is a grasping scissor forceps device used for endoscopic submucosal dissection (ESD). This device can grasp and incise the target tissue similar to the action of a biopsy forceps. Therefore, ESD with a Clutch Cutter may be easier and safer than that performed with non-scissor-type knives. This study verified the usefulness of the Clutch Cutter by nonexpert endoscopists during ESD for superficial esophageal cancer.
Methods:
This single-center retrospective cohort study enrolled 125 patients who underwent ESD as a first-line therapy for superficial esophageal cancer between January 2016 and June 2023 at Saiseikai Suita Hospital. The patients were divided into groups based on the ESD device: a Clutch Cutter or a non-scissor-type device (dual knife). The clinical characteristics and technical outcomes were compared between the two groups.
Results:
Among one hundred twenty-five patients, seventy-nine patients underwent nonexpert endoscopic treatment, of which twenty-one patients underwent ESD with a Clutch Cutter and fifty-eight patients with a dual knife. There is a significant difference in sex distribution between the two groups, with a higher percentage of males in the dual knife group (94.8%) compared to the Clutch Cutter group (71.4%) (p = 0.01). Patients in the Clutch Cutter group had shorter procedure times (60 min) than those in the dual knife group (93 min) (p = 0.002). However, en bloc and R0 resection rates were not significantly different between the groups. In the multivariate analysis, procedure time (min) was significantly correlated with device type (coefficient 58.86, 95% confidence interval: 26.99-90.72) and tumor size (coefficient 4.9, 95% confidence interval: 3.58-6.21).
Conclusion:
ESD for superficial esophageal cancer with the Clutch Cutter significantly shortened procedure time compared to that with the dual knife for nonexpert endoscopists. Therefore, the Clutch Cutter may be a preferred-device for nonexpert endoscopists.
