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HookKnife

Model KD-620LR

Dr. Tsuneo Oyama
Saku Central Hospital

Model KD-620LR

Dr. Tsuneo Oyama
Saku Central Hospital

Interview With The Expert

What are the advantages of HookKnife?
Above all,

it’s safer than a needle knife because it hooks the mucosa for incision and dissection so it is less invasive for the deeper tissues. The rotary function provides another advantage, the ability to align the knife horizontally or vertically. Marking with the back of HookKnife will reduce the risk of perforation. In addition, safer use is possible by mounting an attachment to the endoscope’s distal end to maintain the field of view and by pulling the mucosa into the attachment before supplying current. The capability to perform dissection by directly observing the submucosal layer enables precoagulation. It is nice to be able to perform dissection with a good view and no bleeding.

Are there any weak points of HookKnife?
Due to the fact that the hook length is 1.3 mm long,

it is unavoidable to say that the cutting amount for each time is not plentiful.

Under what circumstances do you also use other devices?
I use a needle knife for circumferential incision.

The needle knife is convenient because its cutting style is like flicking the tissue. Also ITknife and FlexKnife have a higher vertical incision speed so I sometimes use them instead of HookKnife.

Applicability of HookKnife

Difficulty per region

◯ : Easy.  No mark: Ordinary.  △ : Difficult.

Cardiac region    
 Fornix  △  
 Lesser curvature of upper body  ◯  
 Greater curvature of upper body  △  
 Anterior wall of upper body    
 Posterior wall of upper body    
 Lesser curvature of middle body  ◯  
Greater curvature of middle body  △  
 Anterior wall of middle body    
 Posterior wall of middle body    
 Lesser curvature of lower body  
 Greater curvature of lower body  
 Anterior wall of lower body  
 Posterior wall of lower body  
 Lesser curvature of anterior wall    
 Greater curvature of antrum  
 Anterior wall of antrum  
 Posterior wall of antrum  
 Pyloric ring  

Recommendation for beginners: 1) It is important to begin by observing the experts’ procedures. 2) Start with UL(-) lesion of 2 cm or less.
3) After you experience about 10 cases, observe procedures performed by experts again.

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