使用螺旋钉缝合系统进行内镜黏膜下剥离术的多点可调牵引：病例系列
Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series.
作者信息
Kadkhodayan Kambiz S, Irani Shayan, Chandan Saurabh, Pathak Sagar, Abbasi Abdullah, Hayat Maham, Hasan Muhammad K, Yang Dennis
机构信息
Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.
Virginia Mason Medical Center, Seattle, Washington, USA.
出版信息
VideoGIE. 2025 Mar 14;10(7):372-375. doi: 10.1016/j.vgie.2025.03.001. eCollection 2025 Jul.
BACKGROUND AND AIMS
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.
METHODS
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.
RESULTS
The traction technique was successfully applied in 3 patients.
CONCLUSIONS
Multipoint adjustable traction using the helix tack system resulted in improved submucosal visualization, lesion stability, and adaptability during ESD. Further research is needed.
背景与目的
黏膜下层平面的最佳暴露对于有效的内镜黏膜下剥离术（ESD）至关重要。牵引的应用可改善视野和切除效率，但大多数所描述的技术依赖于非适应性单点固定。
方法
我们描述了一种使用X-Tack内镜螺旋钉合系统的新型多点、可调节牵引技术。在病变边缘周围放置三个钉，第四个钉固定在结肠的对侧壁上。通过拉动聚丙烯缝线，实现向上的多点牵引或“降落伞效应”。这导致病变稳定，并在结直肠ESD期间改善了黏膜下暴露。
结果
牵引技术成功应用于3例患者。
结论
使用螺旋钉系统的多点可调节牵引在ESD期间可改善黏膜下视野、病变稳定性和适应性。需要进一步研究。
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