Technical issues and new devices of ESD of early gastric cancer

Figure 2 New devices. A: Water-jet hybrid knife allows needleless infusion and lifting of the lesion as well as cutting and coagulation at the same time without the need of changing instruments; B: Ball tipped flush knife (Flush knife-BT) features improved hemostatic efficacy and dissection speed compared with standard flush knife; C: Dual knife is a newly-devised version of pre-existing flex knife, having 0.3 mm needle tip shaped like a doorknob makes the needle less likely to slip, simplifies marking and hemostasis; D: Mucosectome is made of non-conducted tip and endo-knife which is located at the side of the non-conducted tip; E: Fork knife has two interchangeable knives, a fixed flexible snare and a forked knife, which form a single working unit, and has an inlet for material injection or saline irrigation during the procedure; F: Grasping-type scissors forceps has a 0.8-mm-wide and 6-mm-long serrated cutting edge to facilitate grasping of tissue; G: Distal attachment helps keep the field of view clear throughout the procedure and can be chosen from various sized and shaped models fitted with endoscopes.