LAUSR

Endoscopic closure of an artificial defect after colorectal endoscopic submucosal dissection (ESD) is useful in preventing adverse events [1], with several closure methods having been developed [2, 3]. While the use of traction facilitates ESD [4], no devices currently exist that can facilitate both traction and closure. An elastic thread delivery hood (Dual Traction Hood; Adachi Co., Ltd., Osaka, Japan and Nomura Medical Device Co., Ltd., Nagano, Japan) that has dual threads with multi-rings inside the cap has been developed for traction use (▶Fig. 1) [5]. We describe a case in which this device was used successfully for traction as well as closure in a rectal ESD (▶Video 1). A 65-year-old man presented with a rectal neuroendocrine tumor (▶Fig. 2). Rectal ESD was performed using a Dual Traction Hood as follows. The first thread was used for the traction. After a submucosal pocket was created followed by a whole circumferential incision, the thread was released from the hood using a hemoclip (HX-610-090; Olympus, Tokyo, Japan). Using hemoclips, the thread was then fixed to the edge of the pocket and the opposite normal mucosa (▶Fig. 3). Traction-assisted ESD was completed successfully, leaving an artificial defect 30mm wide (▶Fig. 4). E-Videos