A Novel Device, the Anglerfish Countertractor, is Easy and Safe to Use in Patients Undergoing Endoscopic Submucosal Dissection of Gastric Mucosal Cancer

Endoscopic submucosal dissection (ESD) is a treatment developed to overcome the technical limitations of endoscopic mucosal resection (EMR), ESD permits en bloc resection of larger lesions and achieves a higher rate of histologically complete resection than does conventional EMR. However, ESD is technically more complex and time-consuming than convention EMR. There are occasional complications, most often bleeding and perforation. Because a main reason for these complications is inadequate countertraction during submucosal dissection, an endoscope equipped with the anglerfish countertractor will be introduced in this photogravure. This device was developed by Nobuyuki Sakurazawa of the Department of Surgery, Nippon Medical School. It allows sufficient countertraction and direct visualization of the cutting line, and en bloc resection can be performed without complications. [Fig.1][The anglerfish countertractor] This device consists of 3 springs of different diameters and is attached with a transparent hood to the tip of an endoscope.