Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series

Q3 Medicine

VideoGIE Pub Date : 2025-03-14 DOI:10.1016/j.vgie.2025.03.001

Kambiz S. Kadkhodayan MD , Shayan Irani MD , Saurabh Chandan MD , Sagar Pathak MD , Abdullah Abbasi MD , Maham Hayat MD , Muhammad K. Hasan MD , Dennis Yang MD

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引用次数: 0

Abstract

Background and Aims

Optimal exposure of the submucosal plane is essential for effective endoscopic submucosal dissection (ESD). The application of traction improves visualization and resection efficiency, but most described techniques rely on nonadaptive single-point fixation.

Methods

We describe a novel multipoint, adjustable traction technique using the X-Tack Endoscopic Helix Tacking System. Three tacks are placed around the lesion margin, and a fourth tack is secured to the contralateral wall of the colon. By pulling on the polypropylene suture, upward, multipoint traction or “parachuting effect” was achieved. This resulted in lesion stability and improved submucosal exposure during colorectal ESD.

Results

The traction technique was successfully applied in 3 patients.

Conclusions

Multipoint adjustable traction using the helix tack system resulted in improved submucosal visualization, lesion stability, and adaptability during ESD. Further research is needed.

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多点可调节牵引用于内镜下粘膜剥离螺旋钉缝合系统：一个案例系列

背景与目的黏膜下平面的最佳暴露对于内镜下粘膜下剥离（ESD）是至关重要的。牵引的应用提高了可视化和切除效率，但大多数描述的技术依赖于非自适应单点固定。方法我们描述了一种新的多点、可调牵引技术，使用X-Tack内窥镜螺旋牵引系统。在病变边缘周围放置三枚大头针，第四枚大头针固定在结肠对侧壁。通过拉动聚丙烯缝线，实现了向上、多点牵引或“跳伞效应”。这导致病变稳定性和改善结肠直肠ESD期间粘膜下暴露。结果3例患者均成功应用牵引技术。结论采用螺旋钉钉系统进行多点可调节牵引，可改善ESD术中粘膜下可见性、病变稳定性和适应性。需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.