Endoscopic submucosal dissection using a novel irrigation hood-knife.

Endoscopic submucosal dissection tech− niques using an insulated−tip knife (IT knife) were introduced several years ago to allow en−bloc resection of early gastric cancers, since histological evaluations are essential in order to assess the risk of lymph−node metastasis [1, 2]. However, the technique requires special skills and involves a prolonged procedural time. We have therefore developed a new type of dissection knife, termed the “hood−knife” (patent pending in Japan), which only re− quires a simple technique.