Snaremaster plus

As with a regular colonoscopy, pretreatment consisted of oral administration of 10 mL of 0.75 %
sodium picosulfate and 34 g of magnesium citrate the night before, and 2 L of polyethylene
glycol the morning of the procedure. Examinations and treatments were performed by three
experienced endoscopists. After reaching the cecum, the mode was switched to LCI mode and the
scope was removed. After finding the polyps, BLI magnifying endoscopy was performed. If a polyp
was considered to be adenoma (JNET classification, type 2A) (
Fig. 1), CSP was performed. A 10-mm round snare (SnareMaster Plus,
Olympus, Tokyo, Japan) was used for CSP in all cases. During and after CSP, LCI mode was
retained. A mucosal biopsy was performed at two resection margin sites (right and left), and the
specimen was examined pathologically together with the resected polyp (
Video 1). When bleeding continued for at least 30 seconds after resection, hemostasis was performed with clip. Due to the risk of bleeding associated with biopsy, the upper limit was set at five lesions and 10 biopsies for each patient.

In the present study, ER included CSP, EMR, or ESD. The method that was used for resection depended on lesion size and endoscopic findings, for which the final decision was made by the endoscopist. At our hospital, we attempted en bloc resection of lesions as much as possible, without selecting planned endoscopic piecemeal mucosal resection and piecemeal CSP.
Our institution's polyp resection policy is to remove all detected polyps > 5 mm. Polyps < 5 mm are also basically resected if detected, but some endoscopists follow up JNET type 1 polyps < 5 mm in the distal colon and rectum.
The video processor units EVIS LUCERA SPECTRUM, EVIS LUCERA ELITE, EVIS X1 (Olympus Corporation, Tokyo, Japan), and a single-channel lower gastrointestinal endoscope (PCF-H290ZI, PCF-H290I, PCF-PQ260L, PCF-H290TI, CF-HQ290ZI, PCF-Q260AZI, and PCF-Q260AI) were used.
Disposable high-frequency snare SnareMaster Plus (Olympus Co.), Captivator COLD (Boston Scientific), and COLD SNARE (MC Medical) were used for resection. IN addition, disposable high-frequency knife DualKnife, DualKnife J (KD-655Q or KD-655L, Olympus Co.) and IT-nano knife (KD-612L, Olympus Co.) were used for dissection. For local injection, MucoUP (Boston Scientific, Tokyo, Japan) or K smart (Olympus Co.), a sodium hyaluronate solution, was used for ESD. In addition, saline was used for EMR.