Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2022; 14(11): 667-671
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.667
Optimal traction direction in traction-assisted gastric endoscopic submucosal dissection
Mitsuru Nagata
Mitsuru Nagata, Department of Endoscopy, Shonan Fujisawa Tokushukai Hospital, Fujisawa 251-0041, Kanagawa, Japan
Author contributions: Nagata M has been associated with the conception, drafting of the article, and final approval of the article.
Conflict-of-interest statement: No financial relationships with a commercial entity producing health-care related products and/or services relevant to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Mitsuru Nagata, MD, Chief Doctor, Department of Endoscopy, Shonan Fujisawa Tokushukai Hospital, 1-5-1 Tsujidokandai, Fujisawa 251-0041, Kanagawa, Japan.
Received: September 7, 2022
Peer-review started: September 7, 2022
First decision: September 26, 2022
Revised: October 2, 2022
Accepted: October 14, 2022
Article in press: October 14, 2022
Published online: November 16, 2022
Core Tip

Core Tip: Various traction devices have been developed for endoscopic submucosal dissection (ESD). However, few traction devices have been validated in large-scale studies thus far. The CONNECT-G trial was the first multicenter randomized controlled trial to compare conventional ESD with clip-with-line-assisted ESD for superficial gastric neoplasms. This study suggested that the effectiveness of traction devices in gastric ESD depends on the traction direction; in addition, the most optimal traction direction is vertical to the gastric wall.