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  • Title: Grasping-forceps-assisted endoscopic submucosal dissection using a novel irrigation cap-knife for large superficial early gastric cancer.
    Author: Kume K, Yamasaki M, Yoshikawa I, Otsuki M.
    Journal: Endoscopy; 2007 Jun; 39(6):566-9. PubMed ID: 17554656.
    Abstract:
    The technique of endoscopic submucosal dissection (ESD) needs special skills and involves a long procedure. We therefore developed a new type of dissection knife, the irrigation cap-knife (the Kume cap-knife attachment, which uses a fixed snare), that facilitates ESD by just sliding over the muscle layer with a coagulating current. The ESD procedure using the irrigation cap-knife was performed in seven patients with intramucosal gastric cancer. The tumor was separated from the surrounding normal mucosa using the insulated-tip knife. Submucosal dissection was then performed by pushing our device along the muscle layer while applying a coagulating current, at the same time as a grasping forceps, deployed through the accessory channel, was used to push the lesion away from the muscle layer. The rate of en bloc resection was 100% (7/7). The irrigating cap-knife was extremely useful for ESD of large intramucosal cancers in the stomach.
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