LAUSR

Endoscopic submucosal dissection (ESD) has been established as a minimally invasive treatment modality and has been adopted worldwide for the treatment of early GI tract cancer. However, aspiration pneumonia, a sedation-related adverse event, is reportedly detected on postoperative CT images in 32.0% of cases after esophageal ESD and 6.6% to 14.4% of cases after gastric ESD. Clinical symptoms in the majority of patients are often mild, but symptoms can become serious in elderly patients. Furthermore, because the number of endoscopic treatments for elderly patients is expected to continue to increase in the future, a new strategy is needed to prevent aspiration pneumonia associated with liquid reflux and saliva retention in the oral cavity. Herein, we introduce a continuous saliva suction tube that can be used during endoscopy (Salsuction; Fujifilm Medical Co, Ltd, Tokyo, Japan) (Fig. 1; Video 1, available online at www.giejournal.org). Not only is this device disposable and easy to set up with a mouthpiece (Fig. 2A), it also has 3 other advantageous features. First, it can be directly connected to the tube of the aspirator. Second, the soft tip of the suction tube has multiple slits on its side, making it difficult for the tip to stick to the oral mucosa and cause damage (Fig. 2B). Third, the tube is made from stainless steel, making it malleable and able to maintain a particular shape.