Effectiveness of multi-loop traction device for colorectal endoscopic submucosal dissection in trainees: a pilot study

Colorectal endoscopic submucosal dissection (ESD) is a difficult procedure, and its introduction in trainees have been debated. Although the criteria for starting colorectal ESD vary among institutions, it is often initiated after gaining experience in animal and upper gastrointestinal ESD. This pilot study aimed to compare the treatment outcomes of the trainees using the multi-loop traction device (MLTD group) and the experts’ conventional-ESD (control group), and determine whether MLTD can be used for safe introduction of colorectal ESD in trainees. We included 26 colorectal ESD patients (13 in the MLTD group and 13 in the control group) treated at our hospital from October to December 2021 in the analysis. There were no significant differences in procedure time (50 min vs. 30 min), dissection speed (19.9 mm 2 /min vs. 28.7 mm 2 /min,), and intraoperative perforation (0 % vs. 0 %) between the two groups. Furthermore, the proportion of ESD self-completion in the MLTD group was 100%. Thus, MLTD was used for safe introduction of colorectal ESD even among endoscopists with no experience in colorectal ESD. Subsequently, MLTD may replace animal and upper gastrointestinal ESD in the introduction of colorectal ESD in trainees. Further studies using larger sample sizes need to be conducted.