Advanced endoscopic submucosal dissection with traction

Table 1 Advantages and disadvantages of the traction endoscopic submucosal dissection methods

	Traction			Other advantages	Other disadvantages
	Push	Control of direction	Control of tension
ESD with traction in upper gastrointestinal tract
Clip-with-line method[8,11-14]	-	-	+	Simple, easy
Percutaneous-traction method[15-18]	+	+	+	Regrasping	Invasive
Magnetic anchor method[19,20]	+	+	+		Large and expensive
External forceps method[21,22]	+	-	+	Regrasping, no need of assistant to hold the forceps	Care of mucosal damage
Internal traction method[23-25]	-	-	-	Easy	Roll back of mucosa
Spring-assisted ESD[26]	-	-	-	Easy
Double-channel-scope method[28]	+	+	+	Regrasping	Synchronous movement of forceps and scope
R-scope[29-31]	+	+	+	Regrasping, swing of knife	Thicker and heavier scope, synchronous movement of forceps and scope
Outerroute method[33-38]	+	+	+	Regrasping	Synchronous movement of forceps and scope, small distance between forceps and knife
Double-scope method[10]	+	+	+	Regrasping	Interference of scopes, two light sources, double manpower
Morita[39]	+	+	+	Regrasping, a little interference of scopes	Thicher overtube, two light sources, double manpower
Higuchi[40]	+	+	+	Regrasping, one light source	Interference of scopes, double manpower
Robot-assisted method[42-44]	+	+	+	Regrasping	More complicated, no response of hemostasis
ESD with traction in colon and rectum
Sinker-assisted method[45]	-	-	+	Easy	Retreival of scope
External forceps method[46]	+	-	+	Regrasping	Retreival of scope, only rectum
Internal traction method[47-50]	-	-	-	Easy
Outerroute method[51]	+	+	+	Regrasping	Synchronous movement of forceps and scope
Double-scope method[52,53]	+	+	+	Regrasping	Two light sources and double manpower, interference of t scopes, lesions in only sigmoid colon and rectum
Fusaroli[54]	+	+	+	Regrasping, much cheaper, one light source	interference of scopes, lesions in only sigmoid colon and rectum
Endoscopic surgical platform[55]	+	+	+	Regrasping, freedom offering surgical triangulation	more complicated configuration with fixed instruments, only rectum

ESD: Endoscopic submucosal dissection.