1. Introduction
colorectal ESD, colorectal epithelial tumors
COLORECTAL CANCER, COMPLICATIONS
Endoscopic submucosal dissection (ESD) is a technique that allows the en bloc resection of colorectal epithelial tumors regardless of size. Although ESD is minimally invasive and provides favorable outcomes, it is technically difficult to perform, due in part to a lack of maneuverability, and requires a long procedure time. In addition, patients undergoing colorectal ESD are at particularly high risk of complications due to the thin bowel wall, bowel flexion, and peristalsis, with prolonged colorectal ESD increasing the risk of complications such as perforation.Direct visualization of the submucosal layer, such as by traction of the lesion during mucosal dissection, may make ESD easier to perform. Several techniques involving traction of the lesion have been reported to be effective in ESD for early-stage colorectal cancer.Photograph and schema of the S-O clip traction device. The spring effect provides continuous traction on the lesion, facilitating visualization of the avulsed surface.