Use of adaptive traction for endoscopic submucosal dissection when using a bipolar knife for cardiological reasons

Endoscopic submucosal dissection (ESD) allows en bloc resection of gastrointestinal lesions, providing completeness of resection and facilitating accurate histological assessment. The knives currently in use for ESD are monopolar devices that can cause electromagnetic interference with cardiac implantable electronic devices (CIEDs). Speedboat (Speedboat-RS2; Creo Medical Ltd, Chepstow, UK) is a novel bipolar device designed for ESD, which utilizes advanced energy (radiofrequency and microwave) for dissection and coagulation. It is an all-in-one device, capable of executing submucosal injection, dissection, and coagulation, making the procedure faster without interfering with CIEDs [1]. We report the use of this device during ESD with an adaptive traction instrument (A-TRACT 2+2; Hospices civils de Lyon, Lyon, France), the benefits of which have been described previously ([Video 1]) [2] [3] [4] [5].