| Theme | Towards Standardization of ESD Procedures | |
|---|---|---|
| Title | A Basic and Safe Procedure for Esophageal Endoscopic Submucosal Dissection Using a Hook Knife | |
| Publish Date | 2017/04 | |
| Author | Dai Hirasawa | Department of Gastroenterology, Sendai Kousei Hospital |
| Author | Rintaro Hashimoto | Department of Gastroenterology, Sendai Kousei Hospital |
| Author | Ippei Tanaka | Department of Gastroenterology, Sendai Kousei Hospital |
| Author | Hajime Yamaoka | Department of Gastroenterology, Sendai Kousei Hospital |
| Author | Tomoki Matsuda | Department of Gastroenterology, Sendai Kousei Hospital |
| Author | Masato Nakahori | Department of Gastroenterology, Sendai Kousei Hospital |
| Author | Akimichi Chonan | Department of Gastroenterology, Sendai Kousei Hospital |
| [ Summary ] | Keeping a good endoscopic field of view during endoscopic submucosal dissection (ESD) is important for achieving a safe procedure. Because the esophagus is a narrow organ, keeping a good field of view is occasionally difficult. Furthermore, bleeding easily worsens the field of view in such an environment. A well‒prepared treatment strategy to overcome such conditions should be in place before the procedure. A hook knife has a tip bent at a right angle, making it possible to hook the mucosa and the submucosal tissues under direct vision. Safe ESD can be achieved by advancing this knife during incision of the mucosa and dissection of the submucosa toward the luminal side away from the muscularis propria may be carried out with this knife. It is possible to thoroughly coagulate vessels and to safely dissect the narrow lumen because the hook knife can grasp tissues. In this article, we describe the practical use of a hook knife and a strategy for safe esophageal ESD. | |