The combination of “SB knife” and counter-traction technique (Three-channeled method) of Endoscopic Submucosal Dissecton (ESD) for Colonic tumors

We have contrived and enforced the “Three-channeled method” as a new technique of ESD for the colonic tumors. In this study, we used scissors-shaped cutting device “SB knife, Jr type” (Sumitomo Bakelite Co.,Ltd) which had developed for colorectal use. “Three-channeled method” is worked out as one kind of counter-traction technique, which use two-channeled colonoscope, added the third channel outside the scope. Through these channels, we can use some different type of devices to enforce the operations, to say, local injection, lifting up and dissection of the tumor. With this method, we can get a wide view of dissecting field, and SB knife will contribute for more safe cutting procedure, because it works mainly in pulling back action. Five cases of colonic ESD using the “Three-channeled method with SB knife” is discussed in this study. The mean diameter of removal tissue is 37.6mm and the average removing time is 57.4 minutes, which reveals no statistical difference from 79 cases of conventional method. We didn′t experienced any severe complications as perforations nor hemorrhages. It judged that this technique is very useful in performing the colonic ESD more safely.