A new sinker-assisted endoscopic submucosal dissection for colorectal cancer

Gastrointest Endosc. 2005 Aug;62(2):297-301. doi: 10.1016/s0016-5107(05)00546-8.


Background: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficulty. Thus, a noninvasive tool that facilitates the direct visualization of the submucosal layer is needed.

Methods: Traction-assisted dissection was performed on 4 superficial lesions. The system consisted of a metallic clip attached by a nylon line to a sinker 6 x 4 x 4 mm in size and weighing 1 g. After partially dissecting the submucosa, the clip was attached to the edge of the exfoliated mucosa and the weight of the sinker pulled down the partly resected lesion.

Observations: In all 4 cases, the sinker allowed direct visualization of the cutting line, and en bloc resection was successfully accomplished.

Conclusions: These preliminary results suggest that sinker-assisted ESD is effective for the complete removal of selected superficial early colorectal cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Colonoscopy / methods*
  • Colorectal Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged