Cannula-guided snare with endoclip to assist in endoscopic submucosal dissection: an in vivo animal study.

Assisted endoscopic submucosal dissection (ESD) with mucosal traction remains a challenge. This study explored an approach to assist in esophageal, gastric, colonic, and rectal ESD through a cannula-guided snare with endoclips (CSC-ESD), and aimed to preliminarily evaluate its feasibility in an porcine model. Forty-seven digestive tract mucosae in six pigs were resected using CSC-ESD. The operative time, operative success rate, en bloc resection rate, and intraoperative complications were evaluated. The mean diameter of 12 resected esophageal mucosae was 4.4 ± 1.7 cm and the mean operative time was 24 ± 8 min. The mean diameter of 20 resected gastric mucosae was 3.8 ± 0.9 cm and the operative time was 35 ± 8 min. The mean diameter of 15 resected colonic and rectal mucosae was 3.6 ± 1.0 cm and the operative time was 34 ± 8 min. In all 47 resected mucosae, the en bloc resection rate was 100%, the operative success rate was 100%, and the intraoperative perforation rate was 4.3% (2/47) in the colon. No mucosal bruising or massive bleeding occurred during surgery. The results indicated that this novel assistive method is feasible in esophageal, gastric, colonic and rectal ESD. The further research is worthwhile.