Work

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

Year: 2025

Type: article

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.

Source: VideoGIE

DOI: 10.1016/j.vgie.2025.03.001