A novel extracorporeal accessory traction device for gastric endoscopic submucosal dissection

For early gastric cancer, endoscopic submucosal dissection (ESD) has been established as a standard treatment. However, ESD is associated with several complications, such as bleeding and perforation, which makes ESD difficult for entry-level operators [1]. A clear surgical view can reduce the occurrence of complications, shorten the operating time, and reduce the difficulty of the operation. As a result, various traction methods and devices have been developed and used during ESD [2]. The first author has developed a novel extracorporeal accessory traction device for gastric ESD, which in our opinion can make it easier and safer. The extracorporeal part of the traction device consists of an adjustable power unit, mechanical arms, pulleys, and a spring that provides traction to the mechanical arms (▶Fig. 1). In the case described here, a flat lesion (IIa, 20mm in diameter) was located in the gastric angle (▶Fig. 2). Circumferential mucosal incision was performed first. Then, a line from the traction device was attached to an endoclip extracorporeally, E-Videos