Inner countertraction facilitating endoscopic submucosal dissection of a difficult early gastric cancer independent of transparent cap.

Abstract

Endoscopic submucosal dissection (ESD) has been applied widely for treatment of early gastric cancer (EGC) [1]. However, for difficult locations, the submucosal vision is often unclear, resulting in prolonged operation time as well as increased risk of bleeding and perforation. Inner countertraction allows for safe and speedy dissection in the colon [2] but not in the stomach. Here, we developed a preliminary inner countertraction method to facilitate ESD of EGC in difficult locations ([Video 1]).