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Takamaru et al. Mini-invasive Surg 2022;6:15 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.120

Technical Note Open Access

Characteristics and uses of IT knife nano

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Hiroyuki Takamaru , Yutaka Saito #
Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
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Authors share co-first authorship.
Correspondence to: Dr. Hiroyuki Takamaru, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji Chu-o-ku, Tokyo
104-0045, Japan. E-mail: htakamar@ncc.go.jp
How to cite this article: Takamaru H, Saito Y. Characteristics and uses of IT knife nano. Mini-invasive Surg 2022;6:15.
https://dx.doi.org/10.20517/2574-1225.2021.120
Received: 28 Oct 2021 First Decision: 18 Jan 2022 Revised: 28 Jan 2022 Accepted: 11 Feb 2022 Published: 12 Mar 2022

Academic Editors: Giulio Belli, Simon Ng Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
IT knife nano® (Olympus Medical Co., Tokyo, Japan) is a knife device specialized for esophageal and colorectal
endoscopic submucosal dissection (ESD). The IT knife nano has a smaller insulated tip than that of the IT knife 2,
making it easier to handle the submucosal layer in the colorectum. The disk behind the insulated tip is also smaller
to reduce thermal damage to the muscle layer. Furthermore, the IT knife nano is considered to have more power for
incision because the IT knife nano has a large amount of electric current at the blade compared to other devices.
Therefore, the IT knife nano can resect a larger amount of submucosal layer tissue at once, enabling a faster and
more reliable detachment of the submucosal dissection as well as a circumferential mucosal incision. When
performing submucosal dissection using an IT knife nano, the knife should be moved from the outside to the inside.
While in a difficult situation, moving the knife gradually from the center (inside) to the outside can help perform a
safe colorectal ESD. The IT knife nano is considered an option for difficult situations, such as lesions with severe
fibrosis, or when rapid submucosal dissection is required. We herein provided technical aspects of the IT knife nano
in detail and compared it with other needle-type devices.

Keywords: Colorectal ESD, endoscopic submucosal dissection, technical tips

INTRODUCTION
[2]
[1]
Hosokawa et al. and Ono et al. originally developed the IT knife® (Olympus Medical Co., Tokyo, Japan)
to perform gastric endoscopic submucosal dissection (ESD) more safely and more effectively compared to
the needle-type devices. Subsequently, the IT knife nano® (Olympus Medical Co., Tokyo, Japan), specialized

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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