Theme |
Selection of the therapeutic methods (EMR or ESD) for colorectal tumor |
Title |
Selection of snares for endoscopic mucosal resection, in terms of physical efficacy |
Author |
Hiro-o Yamano |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Kenjiro Yoshikawa |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Tomoaki Kimura |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Ryusuke Kato |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Taku Harada |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Shinya Ishigooka |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Manabu Sawaya |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Ryo Takagi |
Division of Gastroenterology, Akita Red Cross Hospital |
Author |
Kentaro Sato |
Division of Gastroenterology, Akita Red Cross Hospital |
[ Summary ] |
There are various types of snares for endoscopic mucosal resection (EMR). Some endoscopists may choose a snare according to their personal preferences, but we supposed some physical factors were behind those preferences. In this paper, we raise the questions, "What is the best snare for EMR?", and "What are the reasons for those preferences?". In terms of dynamics, the most important element was considered to be vertical force, which may be applied to the mucosa through the snare. We considered two situations ; the first was one in which we keep the tool horizontal facing the loop snare (we defined it as the HPW ; horizontal faced position weight). The other situation was where these was a raised position (we defined it as RPW). We also inspected these forces for seven different snares, and calculated the "effective range" which was termed RPW minus HPW as an average. The results demonstrated that both "Spiral snare" and "Snare Master" showed higher ranges of efficacy than other snares for HPW, RPW and in terms of "effective range". Based on our study, we judged them as the best snares for EMR in terms of physics and logicality. |