Figure 1.

Esophageal ESD using the clip-with-line method on live pigs.

(a) The operative process was as follows: (i): Mucosal incision was performed on the anal side. (ii) & (iii): Circumferential incision was carried out. (iv): The clip-with-line was attached to the oral edge for traction. (v): Submucosal dissection was carried out.

(b) Mucosal incision was performed firstly on the anal side by a dual knife.

(c) & (d) Circumferential incision was completed by an IT2 knife.

(e) The clip tied by a dental floss was attached to the oral edge of the lesion, and the line was pulled in the oral direction for traction.

(f) Submucosal dissection was carried out by an IT2 knife.

ESD, endoscopic submucosal dissection.