Traction with snare during endoscopic submucosal dissection of a gastrointestinal stromal tumor in the gastric fundus

A clear view is necessary for safe and effective endoscopic submucosal dissection (ESD) [1]. Recently, the dental floss and endoclip method has been reported to improve visualization of the submucosal layer [2]. However, the dental floss may injure the surrounding tissue by mechanical cutting. Second, the anchorage of the target lesions can sometimes be easily dislodged. Third, conventional endoclips allow only one opportunity to grasp the tissue, and thus a new endoclip would be needed when anchoring was dislodged or inappropriately applied, which would waste time. To overcome these issues, we have designed a novel method, using a snare to help provide traction during ESD of a gastrointestinal stromal tumor (GIST) in the gastric fundus.