Mori H, Rafiq K, Kobara H, Nishiyama N, Fujihara S, Yachida T, Ayagi M, Tani J, Miyoshi H, Masaki T. An effective and safe gastric endoscopic submucosal dissection in the right lateral position using an inverted overtube. World J Gastroenterol 2014; 20(6): 1623-1625 [PMID: 24587640 DOI: 10.3748/wjg.v20.i6.1623]
Corresponding Author of This Article
Hirohito Mori, MD, PhD, Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793, Japan. hiro4884@med.kagawa-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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Hirohito Mori, Kazi Rafiq, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tatsuo Yachida, Maki Ayagi, Joji Tani, Hisaaki Miyoshi, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kagawa 761-0793, Japan
Author contributions: Mori H was responsible for conceiving the research and drafting the article; Rafiq K, Kobara H, Nishiyama N, Fujihara S, Yachida T, Ayagi M, Tani J and Miyoshi H participated equally in the work; Masaki T provided a critical revision of the manuscript for intellectual content and was responsible for the final approval of the manuscript.
Correspondence to: Hirohito Mori, MD, PhD, Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793, Japan. hiro4884@med.kagawa-u.ac.jp
Telephone: +81-87-8912156 Fax: +81-87-8912158
Received: September 10, 2013 Revised: October 12, 2013 Accepted: November 3, 2013 Published online: February 14, 2014 Processing time: 160 Days and 17.7 Hours
Abstract
Previously, we reported the efficacy of a newly developed inverted overtube in shortening the hemostatic time and obtaining a clear endoscopic view in emergency endoscopic hemostasis. This device also helped us to perform gastric endoscopic submucosal dissection (ESD) more safely by changing the direction of gravity in the right lateral position. To perform a safe ESD, it is important to make an appropriate angle and distance between the electric knife and the gastric mucosa. In this position, the distance to gastric mucosa is reduced, and the angle of the electric knife changes from vertical to somewhat oblique, facilitating safer cutting.
Core tip: In gastric endoscopic submucosal dissection (ESD), the patient’s position must be altered according to the direction of gravity to use an appropriate angle and distance between electric knife and mucosa for safety as well as colorectal ESD.
