Diagnostic endoscopic submucosal dissection for invasive cancer with the four cardinal points traction strategy.

Endoscopic submucosal dissection (ESD) is the reference technique to achieve en bloc resection of a superficial neoplasm located in the gastrointestinal tract [1]. Nevertheless, this method is technically challenging, can be time-consuming, and is often reserved for experts. New strategies to facilitate the procedure are requested. Although countertraction strategies by enlarging the submucosal space, like in the clip and rubber band approach,...