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, 9 (7), 334-340

Endoscopic Submucosal Dissection of Gastric Adenomas Using the Clutch Cutter


Endoscopic Submucosal Dissection of Gastric Adenomas Using the Clutch Cutter

Kazuya Akahoshi et al. World J Gastrointest Endosc.


Aim: To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) using the clutch cutter (CC) (ESD-CC) for gastric adenoma (GA).

Methods: From June 2007 to August 2015, 122 consecutive patients with histological diagnoses of GA from specimens resected by ESD-CC were enrolled in this prospective study. The CC was used for all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment), and its therapeutic efficacy and safety were assessed.

Results: Both the en-bloc resection rate and the R0 resection rate were 100% (122/122). The mean surgical time was 77.4 min, but the time varied significantly according to tumor size and location. No patients suffered perforation. Post-ESD-CC bleeding occurred in six cases (4.9%) that were successfully resolved by endoscopic hemostatic treatment.

Conclusion: ESD-CC is a technically efficient, safe, and easy method for resecting GA.

Keywords: Clutch cutter; Endoscopic submucosal dissection; Gastric adenoma.

Conflict of interest statement

Conflict-of-interest statement: Kazuya Akahoshi and Hidefumi Akahane (FUJIFILM) have applied for the patent in Europe for the Clutch Cutter described in this article. Japan, China, and the United states have already granted the patent. The authors claim no other conflicts of interest.


Figure 1
Figure 1
Learning curves. Video 1: The clutch cutter mechanism; Video 2: The basic ESD technique, using the clutch cutter; Video 3: Endoscopic view of ESD using the clutch cutter on gastric adenoma on the greater curvature of the lower gastric body. ESD: Endoscopic submucosal dissection.

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