High‐Performance Dedicated Snares with Tip Attachments can Overcome Current Disadvantages in Cold Snare Polypectomy

Abstract

Cold snare polypectomy (CSP) has the disadvantage of a lower histopathological complete resection rate (HCRR) because blunt resection using CSP‐dedicated snares (DSs) causes mucosal retraction into the sheath during capture/resection. In this study, attachments are designed to narrow the sheath tip's inner diameter from 1.8 to 1.3‒1.1 mm to prevent mucosal retraction. Eight prototype snares with different component characteristics are combined with these attachments. Additionally, product version DS with attachment (Smart Snare Cold) and existing DSs, such as Exacto Cold Snare, are prepared. For snare performance evaluation, the force required to resect (FRR) human colonic mucosa, mucosal retraction amount (MRA), and clinical data are obtained. The attachments that narrowed the inner diameter to 1.3 or 1.1 mm reduce the FRR to 74.9%−93.8% and 68.0%−84.9%, respectively, and reduce the MRA to 21.0%−35.3% and 15.1%−26.8%, respectively. Thus, the reduced inner diameter improves resection ability and prevents mucosal retraction. The clinical findings show that Smart Snare Cold has significantly higher muscularis mucosa resection rates and HCRRs than Exacto Cold Snare (P < 0.001 and P = 0.003, respectively). Thus, the novel DS with tip attachment improves the HCRR and overcomes the current CSP disadvantage by simultaneously improving resection ability and preventing mucosal retraction.