Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series

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...

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Main Authors: Kambiz S. Kadkhodayan, MD, Shayan Irani, MD, Saurabh Chandan, MD, Sagar Pathak, MD, Abdullah Abbasi, MD, Maham Hayat, MD, Muhammad K. Hasan, MD, Dennis Yang, MD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:VideoGIE
Online Access:http://www.sciencedirect.com/science/article/pii/S246844812500044X
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author Kambiz S. Kadkhodayan, MD
Shayan Irani, MD
Saurabh Chandan, MD
Sagar Pathak, MD
Abdullah Abbasi, MD
Maham Hayat, MD
Muhammad K. Hasan, MD
Dennis Yang, MD
author_facet Kambiz S. Kadkhodayan, MD
Shayan Irani, MD
Saurabh Chandan, MD
Sagar Pathak, MD
Abdullah Abbasi, MD
Maham Hayat, MD
Muhammad K. Hasan, MD
Dennis Yang, MD
author_sort Kambiz S. Kadkhodayan, MD
collection DOAJ
description 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.
format Article
id doaj-art-4e2fc72c7c924980bcd9561c754cc5a9
institution Kabale University
issn 2468-4481
language English
publishDate 2025-07-01
publisher Elsevier
record_format Article
series VideoGIE
spelling doaj-art-4e2fc72c7c924980bcd9561c754cc5a92025-08-20T03:24:07ZengElsevierVideoGIE2468-44812025-07-0110737237510.1016/j.vgie.2025.03.001Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case seriesKambiz S. Kadkhodayan, MD0Shayan Irani, MD1Saurabh Chandan, MD2Sagar Pathak, MD3Abdullah Abbasi, MD4Maham Hayat, MD5Muhammad K. Hasan, MD6Dennis Yang, MD7Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA; Corresponding author: Kambiz S. Kadkhodayan, MD, 3883 Ethan Lane, DE–01062, Orlando, Florida 2814, USA.Virginia Mason Medical Center, Seattle, Washington, USACenter for Interventional Endoscopy, AdventHealth, Orlando, Florida, USACenter for Interventional Endoscopy, AdventHealth, Orlando, Florida, USACenter for Interventional Endoscopy, AdventHealth, Orlando, Florida, USACenter for Interventional Endoscopy, AdventHealth, Orlando, Florida, USACenter for Interventional Endoscopy, AdventHealth, Orlando, Florida, USACenter for Interventional Endoscopy, AdventHealth, Orlando, Florida, USABackground 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.http://www.sciencedirect.com/science/article/pii/S246844812500044X
spellingShingle Kambiz S. Kadkhodayan, MD
Shayan Irani, MD
Saurabh Chandan, MD
Sagar Pathak, MD
Abdullah Abbasi, MD
Maham Hayat, MD
Muhammad K. Hasan, MD
Dennis Yang, MD
Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
VideoGIE
title Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
title_full Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
title_fullStr Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
title_full_unstemmed Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
title_short Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series
title_sort multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system a case series
url http://www.sciencedirect.com/science/article/pii/S246844812500044X
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