LAUSR

Colorectal endoscopic submucosal dissection (ESD) is a useful technique for resecting large colorectal tumors, but it is technically difficult. The difficulties include patients’ breathing, presence of severe fibrosis, and difficult locations. One difficult location is the dentate line area because of an abundance of hemorrhoidal vessels (Fig. 1). Clutch Cutter (Fujifilm Co, Tokyo, Japan) is a unique scissor-shaped serrated knife (Fig. 2A). This knife enables mucosal incision and submucosal dissection. Tissue is caught with this knife and then cut or dissected electrosurgically. The outside of the