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Endoscopic submucosal dissection for gastric neoplasia : Experience with the flex-knife

Journal Volume 69 - 2006
Issue Fasc.2 - Case series
Author(s) S. Kodashima, M. Fujishiro, N. Yahagi, N. Kakushima, M. Ichinose, M. Omata
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(1) Department of Gastroenterology, Graduate school of Medicine, University of TokyO. TokyO. Japan ; (2) Department of Gastroenterology, Toranomon Hospital, TokyO. Japan ; (3) Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.

Although the standard treatment for gastric neoplasia is still surgical resection, endoscopic resection has been accepted for some of these lesions in an early stage. Among several methods of endoscopic resection, endoscopic submucosal dissection has been developed to remove the lesions in an en bloc fashion regardless of size, shape, coexisting ulcer, and location. However, indication of endoscopic submucosal dissection is strictly confined by two aspects ; those are the possibility of nodal metastases and techni- cal difficulty. Nowadays, several knives for endoscopic submucos- al dissection are available and each of them has some merits and demerits. We describe how to perform endoscopic submucosal dis- section in the stomach by using the flex-knife, a new endoscopic device specifically designed for submucosal dissection, emphasiz- ing its special features from our experience. (Acta gastroenterol. belg., 2006, 69, 224-229).

© Acta Gastro-Enterologica Belgica.