Table 4.

Advantages and Disadvantages of Traction Methods

	Advantage	Disadvantage
Esophagus
Clip and line	Simple and easy, invariably provide traction proximally	Uncontrollable traction direction
	Controllable traction tension
Tunneling	No device required, controllable traction tension	Uncontrollable traction direction
Stomach
Sheath-assisted	Simple and easy	Difficult controlling traction direction
	Controllable traction tension	Synchronous movement of sheath and scope
Clip and line	Simple and easy, controllable traction tension	Uncontrollable traction direction
		Synchronous movement of scope and line
Double scope	Controllable traction tension and direction	Synchronous movement of forceps and scope
Elastic band/S-O clip	Controllable traction direction	Uncontrollable traction tension
	Independent movement of scope and device
Tunneling	No device required, controllable traction tension	Uncontrollable traction direction
		Challenging hemostasis for massive bleeding inside tunnel
Pocket creation	No device required, controllable traction tension	Technically demanding to complete mucosal incision after pocket creation
		Challenging hemostasis for massive bleeding inside pocket
Colorectum
Double scope	Controllable traction tension and direction	Inapplicable to the proximal colon
		Synchronous movement of forceps and scope
Clip and line	Applicable to the proximal colon	Uncontrollable traction direction
		Synchronous movement of scope and line
Elastic band/S-O clip	Controllable traction direction	Uncontrollable traction tension
	Applicable to the proximal colon
	Independent movement of scope and device
Pocket creation	No device required, controllable traction tension	Technically demanding to complete mucosal incision after pocket creation
	Applicable to the proximal colon
Magnetic beads	Controllable traction direction and tension	Limited availability and high medical cost
	Applicable to the proximal colon
	Independent movement of scope and device