Traction wire assisted ESD of a hepatic flexure LST NG pseudodepressed

Short video of use of traction wire - Medtronic ProdiGI use in a ESD of a hepatic flexure LST NG type leaning towards pseudodepressed type , but can argue its flat type

Few points about LST NG Pseudodepressed type

1. High risk of Sm invasive malignancy- approx 40 %
2. Tend to have multifocal Sm invasion within the polyp
3. Donot lift well with due to fibrosis
4. Snare resection is difficult especially > 2 cms due to snare slippage
5. One of the important indication for ESD - Enbloc resection