Grasping forceps–assisted endoscopic mucosal resection of early gastric cancer with a novel 2-channel prelooped hood

BackgroundEndoscopic mucosal resection with a cap-fitted panendoscope (EMRC) such as a soft prelooped hood is a useful, effective, and safe technique. One problem with this method is that the lesion cannot always be maintained in the center of the cap because the procedure is performed blindly after aspiration.ObjectiveWe developed a 2-channel prelooped hood that facilitates EMRC while simultaneously allowing both grip of the center in the lesion and irrigation of the aspiration site and evaluated the usefulness of this end hood for early gastric cancer.DesignRetrospective study.SettingBetween August 2003 and October 2004, patients underwent our novel EMR.PatientsTwelve cases of early gastric cancer.InterventionsTwo side holes were fabricated by drilling in the cap portion of a conventional soft prelooped hood, and then the irrigation tube and the accessory channel tube were glued to the exterior surface of the holes. We placed the fabricated transparent hood at the tip of the endoscope and performed grasping forceps–assisted endoscopic aspiration mucosectomy.Main Outcome MeasurementsAccurate aspiration and the rate of en bloc resection.ResultsWe obtained a satisfactory field of view and accurate aspiration in the center of the tumor in all lesions. The rate of en bloc resection was 91.7% (11/12).LimitationsGastric intramucosal cancer.ConclusionGrasping forceps–assisted endoscopic mucosal resection with a novel 2-channel prelooped hood is safe and useful for mucosal resection of intramucosal cancers less than 20 mm and may help center the lesion in the cap before resection.