A novel traction method using multi loop traction device in colorectal endoscopic submucosal dissection

Background: We devised a novel traction method called the anchor traction method that enables three points traction with a single multi-loop traction device (MLTD). The details of the method are as follows: The middle loop of MLTD is grasped with sureclip and attached to the anal side of the lesion after full circumferential incision. The side loops of MLTD are grasped with different clips and attached to the mucosa of sides of the lesion, respectively. Finally, the middle loop is grasped with another clip and attached to the opposite side enabling three points traction. Here, we assessed the colorectal ESD using the anchor traction method compared to that of conventional traction with one point.
Methods: We reviewed 74 ESD cases using traction device between February 2023 and January 2025. The primary outcome was the operation time, and secondary were resection speed, en bloc resection, and complications in anchor traction and conventional traction groups.
Result: Ot the 74 cases, 40 cases were resected using anchor traction and 34 were using conventional traction. Anchor traction group had significantly shorter operation times (39 min vs 51 min, p=0.04) than conventional. The resection speed was also significantly faster (17.9mm2/min:11.6mm2/min, p<0.01). No significant differences in en bloc resection and complications were observed.
Conclusion: Anchor traction method is beneficial compared with conventional in improving operation time and resection speeds.