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Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
Journal article   Open access   Peer reviewed

Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series

Kambiz Kadkhodayan, Shayan Irani, Saurabh Chandan, Sagar Pathak, Abdullah Abbasi, Maham Hayat, Muhammad K Hasan and Dennis Yang
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, Vol.10(7), pp.372-375
07/01/2025
DOI: 10.1016/j.vgie.2025.03.001
PMCID: PMC12237850
PMID: 40642408
url
https://doi.org/10.1016/j.vgie.2025.03.001View
Published (Version of record) Open Access

Abstract

Optimal exposure of the submucosal plane is essential for effective endoscopic submucosal dissection (ESD). The application of traction improves visualization and resection efficiency, but most described techniques rely on nonadaptive single-point fixation. We describe a novel multipoint, adjustable traction technique using the X-Tack Endoscopic Helix Tacking System. Three tacks are placed around the lesion margin, and a fourth tack is secured to the contralateral wall of the colon. By pulling on the polypropylene suture, upward, multipoint traction or “parachuting effect” was achieved. This resulted in lesion stability and improved submucosal exposure during colorectal ESD. The traction technique was successfully applied in 3 patients. Multipoint adjustable traction using the helix tack system resulted in improved submucosal visualization, lesion stability, and adaptability during ESD. Further research is needed. [Display omitted]
 ESD

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