Is there a best choice of equipment for colorectal endoscopic submucosal dissection?

ABSTRACT

Introduction

Endoscopic submucosal dissection (ESD) is a widely used technique to remove early neoplastic lesions. It was primarily used in the initial days to treat gastric lesions, but recently, the horizon of this endoscopic procedure has expanded, which has allowed us to manage other technically more complex locations, such as the colorectum.

Areas covered

There has been an exponential growth regarding the wide range of devices available in the market for performing colorectal ESD. As a result, the aim of this review is to highlight the indication of this endoscopic technique, which device is best suited for which indication, as well as future trajectories in this field.

Expert opinion

Although some devices have proven to be more advantageous than others in this area, very often the choice is still subjective, which is commonly attributed to individual preferences and experience. However, an accurate knowledge of the available tools and their functioning, with their pros and cons, is fundamental for any endoscopist venturing into the field of third space endoscopy. In this way, one can choose which device best suits a particular situation, along with simultaneously having the wealth of knowledge related to therapeutic armamentarium at our disposal in the endoscopy suite.

KEYWORDS:

• Polyps
• ESD
• complications
• devices
• knives
• tractions

Article highlights

• Endoscopic submucosal dissection (ESD) is a widely used endoscopic resection technique to remove early neoplastic lesions.

• With the expanding horizon of third space endoscopy, research is progressing, and consequently new devices have been commercialized.

• Knowing their individual characteristics and the available evidence for managing the lesions in the colorectal area will allow a conscious and accurate choice of equipment for colorectal ESD.

Declaration of interest

Antonio Capogreco is a consultant for ERBE; Roberta Maselli is a consultant for ERBE, Fujifilm, 3DMatrix, and Boston Scientific; Alessandro Repici is a consultant for Medtronic, ERBE, Fujifilm, and Olympus; Cesare Hassan is a consultant for Fujifilm and Medtronic. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.