{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:39:30Z","timestamp":1780544370415,"version":"3.54.1"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Endoscopic submucosal dissection (ESD) is a technique used for resection of large neoplastic lesions, providing great oncological outcomes. However, ESD is technically challenging with a long learning curve, high complication rates, and extended procedure times. To address these limitations, various traction-assisted methods have been developed. This study evaluated a novel through-the-scope traction device (TRACMOTION, Fujifilm, Japan), which offers consistent and adjustable traction, in a pilot multicenter randomized ex vivo trial.<\/jats:p><jats:p>The study included six endoscopists with limited ESD experience performing ESD on ex vivo porcine stomach models. Participants were randomized into two groups: those using TRACMOTION-assisted ESD (TM-ESD) and those performing conventional ESD (C-ESD). Each trainee completed six procedures, split equally between both groups. The primary outcome was resection speed, whereas secondary outcomes included en bloc, R0 resection rates, perforation rates, and rates of speedy procedures (&gt;20 mm\u00b2\/min).<\/jats:p><jats:p>The TM-ESD group achieved a higher median resection speed of 20.75 mm\u00b2\/min (95% confidence interval [CI] 14.56\u201329.25) in comparison to 15.10 mm\u00b2\/min (95% CI 12.8\u201316.6) in the C-ESD group (P=0.02). Perforation rates were significantly lower in the TM-ESD group (11.1% (95% CI 0.01\u20130.34) vs. 61.1% (95% CI 0.35\u20130.82; P=0.0002). No significant differences were observed in en bloc or R0 resection rates between the groups.<\/jats:p><jats:p>TRACMOTION significantly improves the efficiency of ESD, reducing procedure time and complication rates. This traction device could potentially facilitate broader adoption of ESD in clinical practice. However, further research in human trials is necessary to validate these findings.<\/jats:p>","DOI":"10.1055\/a-2576-5837","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T22:58:12Z","timestamp":1744066692000},"source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Ex vivo evaluation of a novel through-the-scope traction device for endoscopic submucosal dissection"],"prefix":"10.1055","volume":"13","author":[{"given":"Ludovico","family":"Alfarone","sequence":"first","affiliation":[{"name":"Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6448-2649","authenticated-orcid":false,"given":"Roberto","family":"De Sire","sequence":"first","affiliation":[{"name":"Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, Italy"},{"name":"Gastroenterology, IBD Unit, Department of Clinical Medicine and Surgery, Universit\u00e0 degli Studi di Napoli Federico II, Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, H\u00f4pital Europ\u00e9en Georges Pompidou, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Aidibi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, H\u00f4pital Europ\u00e9en Georges Pompidou, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Cellier","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, H\u00f4pital Europ\u00e9en Georges Pompidou, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7167-1459","authenticated-orcid":false,"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy"},{"name":"Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"},{"name":"Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Rahmi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, H\u00f4pital Europ\u00e9en Georges Pompidou, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Maselli","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1055\/a-1811-7025","article-title":"Endoscopic submucosal dissection for superficial gastrointestinal lesions:\n          European Society of Gastrointestinal Endoscopy (ESGE) Guideline \u2013 Update 2022","volume":"54","author":"P Pimentel-Nunes","year":"2022","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.7326\/M23-1812","article-title":"Endoscopic en bloc versus piecemeal resection of large nonpedunculated colonic adenomas: A randomized comparative trial","volume":"177","author":"J Jacques","year":"2024","journal-title":"Ann Intern Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.gie.2017.02.024","article-title":"Clinical outcomes after endoscopic submucosal dissection for colorectal neoplasia: a systematic review and meta-analysis","volume":"86","author":"L Fuccio","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1055\/a-0996-0912","article-title":"Curriculum for endoscopic submucosal dissection training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement","volume":"51","author":"P Pimentel-Nunes","year":"2019","journal-title":"Endoscopy"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.gie.2018.09.021","article-title":"Gaining traction: pulley-ing your weight during endoscopic submucosal dissection","volume":"1","author":"D Yang","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.gie.2021.01.036","article-title":"Double-clip traction for colonic endoscopic submucosal dissection: a multicenter study of 599 consecutive cases (with video)","volume":"94","author":"P Bordillon","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.gie.2015.07.014","article-title":"Usefulness of a traction method using dental floss and a hemoclip for gastric endoscopic submucosal dissection: a propensity score matching analysis (with videos)","volume":"83","author":"S Suzuki","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1055\/s-0034-1393241","article-title":"Impact of the clip and snare method using the prelooping technique for colorectal endoscopic submucosal dissection","volume":"48","author":"S Yamada","year":"2016","journal-title":"Endoscopy"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.gie.2024.02.032","article-title":"Endoscopic submucosal dissection with adaptive traction strategy: first prospective multicenter study (with video)","volume":"100","author":"J Grimaldi","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"E778","DOI":"10.1055\/a-2117-8444","article-title":"Initial multicenter experience using a novel articulating through-the-scope traction device for endoscopic submucosal dissection","volume":"11","author":"M Hayat","year":"2023","journal-title":"Endosc Int Open"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1007\/s00464-012-2402-5","article-title":"The learning curve for endoscopic submucosal dissection in an established experimental setting","volume":"27","author":"M Kato","year":"2013","journal-title":"Surg Endosc"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"e174","DOI":"10.1002\/deo2.174","article-title":"Novel single-operator through-the-scope traction device for endoscopic submucosal dissection: Outcomes of a multicenter randomized pilot ex-vivo study in trainees with limited endoscopic submucosal dissection experience (with video)","volume":"3","author":"D Yang","year":"2023","journal-title":"DEN Open"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1007\/s00464-009-0724-8","article-title":"Difficulties and outcomes in starting endoscopic submucosal dissection","volume":"24","author":"AYB Teoh","year":"2010","journal-title":"Surg Endosc"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2576-5837.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T23:18:52Z","timestamp":1750202332000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2576-5837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,7]]},"references-count":13,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2025,1,7]]},"published-print":{"date-parts":[[2025]]}},"alternative-id":["a25765837"],"URL":"https:\/\/doi.org\/10.1055\/a-2576-5837","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4,7]]},"published":{"date-parts":[[2025,4,7]]}}}