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Focused Review Series: Endoscopic Accessories Used for ESD
Accessory Devices Frequently Used for Endoscopic Submucosal Dissection
Hyuk Soon Choi, Hoon Jai Chun
Clin Endosc 2017;50(3):224-233.   Published online May 31, 2017
AbstractAbstract PDFPubReaderePub
Endoscopic submucosal dissection (ESD) is increasingly being considered an essential component of treatment for early gastrointestinal cancers and subepithelial tumors. The ESD technique owes its popularity to the development of sophisticated instruments used for ESD. With an increase in the number of ESD procedures performed, there is rapid development in the number and types of endoscopic accessory devices used for such procedures. Despite the large numbers of new devices developed and marketed, the use of ESD instruments and accessory devices is largely determined by individual preferences and experiences. Accessory devices frequently used during ESD are important tools for ESD techniques. Each instrument possesses characteristic advantages and disadvantages associated with its use, and no one instrument is superior in all respects to others. In this article, we review the characteristics of endoscopic electrical knives, cap and hood, and hemostatic devices commonly used in ESD.


Citations to this article as recorded by  
  • Endoscopic Resection of Early Luminal Cancer
    Hyuk Soon Choi, Joo Ha Hwang
    Gastrointestinal Endoscopy Clinics of North America.2024; 34(1): 51.     CrossRef
  • Endoscopic Submucosal Dissection: A Safe and Effective Alternative to Surgical Intervention for Esophageal Hemangioma
    Lu Zhongsheng, Dou Yan, Reem Ezzat, Mu Chen, Yuan Jing, Mohamed El-Kassas, Ahmed Tawheed, Ahmad Madkour
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(2): 124.     CrossRef
  • Improved hydration property of tissue adhesive/hemostatic microparticle based on hydrophobically-modified Alaska pollock gelatin
    Shima Ito, Kazuhiro Nagasaka, Hiyori Komatsu, Debabrata Palai, Akihiro Nishiguchi, Tetsushi Taguchi
    Biomaterials Advances.2024; 159: 213834.     CrossRef
  • Is there a best choice of equipment for colorectal endoscopic submucosal dissection?
    Francesco Cocomazzi, Sonia Carparelli, Nunzia Labarile, Antonio Capogreco, Marco Gentile, Roberta Maselli, Jahnvi Dhar, Jayanta Samanta, Alessandro Repici, Cesare Hassan, Francesco Perri, Antonio Facciorusso
    Expert Review of Medical Devices.2024; : 1.     CrossRef
  • Endoscopic Management of Complex Colorectal Polyps: Current Insights and Future Trends
    Rupinder Mann, Mahesh Gajendran, Chandraprakash Umapathy, Abhilash Perisetti, Hemant Goyal, Shreyas Saligram, Juan Echavarria
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • How to Incorporate Advanced Tissue Resection Techniques in Your Institution
    Alessandro Repici, Roberta Maselli, Cesare Hassan
    Gastroenterology.2022; 162(7): 1825.     CrossRef
  • Preparation and ex vivo investigation of an injectable microparticulate formulation for gastrointestinal mucosa polyp resection
    Cristina Moles-Aranda, Noelia Pérez-González, Ana C. Calpena-Campmany, María J. Martín-Villena, Francisco J. Otero-Espinar, Patricia Severino, Eliana B. Souto, José A. Morales-Molina, Beatriz Clares-Naveros
    European Journal of Pharmaceutics and Biopharmaceutics.2022; 178: 25.     CrossRef
  • Comparison between a novel core knife and the conventional IT knife 2 for endoscopic submucosal dissection of gastric mucosal lesions
    Myeongsoon Park, Jin Wook Lee, Dong Woo Shin, Jungseok Kim, Yoo Jin Lee, Ju Yup Lee, Kwang Bum Cho
    Clinical Endoscopy.2022; 55(6): 767.     CrossRef
  • The Mettle to Use the Petals: Using Over-the-Scope Rings to Optimize Endoscopic Submucosal Dissection
    Mike T. Wei, George Triadafilopoulos, Shai Friedland
    Digestive Diseases and Sciences.2021; 66(4): 989.     CrossRef
  • Successful Endoscopic Resection of Residual Colonic Mucosa-Associated Lymphoid Tissue Lymphoma after Polypectomy
    Jeongmin Choi
    Clinical Endoscopy.2021; 54(5): 759.     CrossRef
  • Endoscopic submucosal dissection: an update on tools and accessories
    Christopher Harlow, Arun Sivananthan, Lakshmana Ayaru, Kinesh Patel, Ara Darzi, Nisha Patel
    Therapeutic Advances in Gastrointestinal Endoscopy.2020; 13: 263177452095722.     CrossRef
  • Advanced Colonic Polypectomy
    Ipek Sapci, Emre Gorgun
    Surgical Clinics of North America.2020; 100(6): 1079.     CrossRef
  • Endoscopic Submucosal Dissection Using Endoscopic Robot: Endoscopist’s Future Destination
    Hang Lak Lee
    Gut and Liver.2019; 13(4): 381.     CrossRef
  • A Pilot Study of Endoscopic Submucosal Dissection Using an Endoscopic Assistive Robot in a Porcine Stomach Model
    Byung Gon Kim, Hyuk Soon Choi, Sei Hoon Park, Jun Ho Hong, Jung Min Lee, Seung Han Kim, Hoon Jai Chun, Daehie Hong, Bora Keum
    Gut and Liver.2019; 13(4): 402.     CrossRef
  • Self-expandable metal stents in patients with postoperative delayed gastric emptying after distal gastrectomy
    Seung Han Kim, Bora Keum, Hyuk Soon Choi, Eun Sun Kim, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Sungsoo Park
    World Journal of Gastroenterology.2018; 24(40): 4578.     CrossRef
  • 10,064 View
  • 257 Download
  • 15 Web of Science
  • 15 Crossref
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Endoscopic Management of Nonvariceal Upper Gastrointestinal Bleeding: State of the Art
Naoki Muguruma, Shinji Kitamura, Tetsuo Kimura, Hiroshi Miyamoto, Tetsuji Takayama
Clin Endosc 2015;48(2):96-101.   Published online March 27, 2015
AbstractAbstract PDFPubReaderePub

Nonvariceal upper gastrointestinal (GI) bleeding is one of the most common reasons for hospitalization and a major cause of morbidity and mortality worldwide. Recently developed endoscopic devices and supporting apparatuses can achieve endoscopic hemostasis with greater safety and efficiency. With these advancements in technology and technique, gastroenterologists should have no concerns regarding the management of acute upper GI bleeding, provided that they are well prepared and trained. However, when endoscopic hemostasis fails, endoscopy should not be continued. Rather, endoscopists should refer patients to radiologists and surgeons without any delay for evaluation regarding the appropriateness of emergency interventional radiology or surgery.


Citations to this article as recorded by  
  • Endoscopic projection of the gastroduodenal artery: Anatomical implications for bleeding management
    P. Wilhelm, D. Stierle, J. Rolinger, C. Falch, U. Drews, A. Kirschniak
    Annals of Anatomy - Anatomischer Anzeiger.2020; 232: 151560.     CrossRef
  • CTA As an Adjuvant Tool for Acute Intra-abdominal or Gastrointestinal Bleeding
    Mitchell Storace, Jonathan G. Martin, Jay Shah, Zachary Bercu
    Techniques in Vascular and Interventional Radiology.2017; 20(4): 248.     CrossRef
  • Clinical Outcomes of Endoscopic Hemostasis for Bleeding in Patients with Unresectable Advanced Gastric Cancer
    In Ji Song, Hyun Ju Kim, Ji Ae Lee, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee, Hyunsoo Chung
    Journal of Gastric Cancer.2017; 17(4): 374.     CrossRef
  • Transcatheter Arterial Embolization for Gastrointestinal Bleeding Secondary to Gastrointestinal Lymphoma
    Lin Zheng, Ji Hoon Shin, Kichang Han, Jiaywei Tsauo, Hyun-Ki Yoon, Gi-Young Ko, Jong-Soo Shin, Kyu-Bo Sung
    CardioVascular and Interventional Radiology.2016; 39(11): 1564.     CrossRef
  • Ulcères gastroduodénaux hémorragiques : étude prospective observationnelle multicentrique en Côte-d’Ivoire
    C. Assi, S. A. Thot’o, M. Diakité, M. F. Bathaix, S. Doffou, A. Ouattara, Y. H. Kissi, A. Coulibaly, D. Bangoura, D. Soro, E. Allah-Kouadio, K. A. Attia, M. J. Lohouès-Kouacou, T. Ndri-Yoman, B. M. Camara
    Acta Endoscopica.2015; 45(6): 297.     CrossRef
  • 13,064 View
  • 173 Download
  • 5 Web of Science
  • 5 Crossref
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Original Article
Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video)
Chang-Il Kwon, Gwangil Kim, Il-Kwun Chung, Won Hee Kim, Kwang Hyun Ko, Sung Pyo Hong, Seok Jeong, Don Haeng Lee
Clin Endosc 2014;47(6):544-554.   Published online November 30, 2014
AbstractAbstract PDFSupplementary MaterialPubReaderePub

In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.


This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.


A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm2/sec vs. 1.57 mm2/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.


ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.


Citations to this article as recorded by  
  • Comparison of synchronous dual wavelength diode laser versus conventional endo-knives for esophageal endoscopic submucosal dissection: an animal study
    Jian Tang, Shufang Ye, Xueliang Ji, Jun Li, Feng Liu
    Surgical Endoscopy.2018; 32(12): 5037.     CrossRef
  • Technological review on endoscopic submucosal dissection: available equipment, recent developments and emerging techniques
    Georgios Mavrogenis, Juergen Hochberger, Pierre Deprez, Morteza Shafazand, Dimitri Coumaros, Katsumi Yamamoto
    Scandinavian Journal of Gastroenterology.2017; 52(4): 486.     CrossRef
  • 7,272 View
  • 60 Download
  • 3 Web of Science
  • 2 Crossref
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