Pre-cutting traction-assisted endoscopic submucosal dissection for rectal neuroendocrine tumors

Pre-cutting traction-assisted endoscopic submucosal dissection for rectal neuroendocrine tumors Fig. 1 a Established traction system: thread-and-endoclip pre-cutting traction device ready for submucosal dissection.b Perilesional mucosal traction: targeted elevation optimizing submucosal plane visualization.c Submucosal dissection using Dual Knife.d Completely dissected lesion en bloc. Fig. 2 a The submucosal lesion.b Establishment of a thread-and-endoclip pre-cutting traction device adjacent to the lesion.c Administration of sodium hyaluronate-methylene blue-saline solution for mucosal lifting.d External traction on the free end of the thread to optimize submucosal exposure.e Mucosal incision with Dual Knife.