A New Device for Better Control of the Polypectomy Snare Wire

When conducting polypectomy procedures, we noticed that it was difficult to control the direction of the snare wire used during resection - especially in the case of large polyps - since the force applied to open the wire acts only in the forward direction, and there is no means of ensuring that the snare wire will rotate in the same direction as the endoscope. Only the surgeon’s skill can then be used for maneuvering and encircling the polyp.

We therefore designed a device (Figure [1]) consisting of a transparent plastic cap provided with two opposite inner retaining edges to prevent the snare from rotating (patented by F. S. Salameh). After the polyp has been located, the snare is pushed until it extends beyond the edge of the plastic cap by about 5 mm; the snare wire is then opened, and it is pulled back into the endoscope channel. The snare is then trapped inside the cap between the two inner edges, and if the endoscope is rotated, the snare will rotate along with it, allowing one to encircle the polyp easily for resection. Another advantage is that the cap can be used as a basket to pull out large polyps when it is difficult to pass these through the anal sphincter [1] [2] [3] [4].

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Figure 1 The transparent plastic cap with two inner retaining edges to prevent the snare wire from rotating.

References

• 1 Inoue H, Tani M, Nagai K. et al . Treatment of esophageal and gastric tumors.  Endoscopy. 1999;  31 47-55
• 2 Salameh F S. A promising new device for use in polypectomy.  Endoscopy. 2002;  34 178
• 3 Inoue H, Takeshita K, Hori H. et al . Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions.  Gastrointest Endosc. 1993;  39 58-62
• 4 Kronborg O. Colon polyps and cancer.  Endoscopy. 2002;  34 69-72