GI Endoscopy · 1 min read
Snare Geometry for Laterally Spreading Tumors (LST)
Discover expert techniques for removing flat polyps from colon, ensuring a safe procedure with minimal risks. Learn more about preventive care.
Clinical Bottom Line
| Snare Morphology | Mechanical Feature | Primary Application |
|---|---|---|
| Stiff Thin-Wire (CSP) | Maintains rigid shape; easily cuts without heat. | Standard Cold Snare Polypectomy for small lesions < 10mm. |
| Braided Braided (HSP) | Thick, braided wire generates higher tissue friction. | Hot Snare Polypectomy; provides superior "grip" on the mucosa during EMR tightening. |
| Spiral or Barbed | Physical ridges woven into the snare loop. | Aggressively anchors into flat, slippery Laterally Spreading Tumors (LST-NG) preventing the snare from slipping off during closure. |
Overcoming the Loss of Grip
When executing an Endoscopic Mucosal Resection (EMR) on a massive 40mm Laterally Spreading Tumor (LST) in the right colon, the endoscopist cannot remove the lesion in a single pass. The tumor must be meticulously removed in a piecemeal fashion (pEMR) following a massive submucosal injection. The preeminent technical challenge during pEMR is snare "slip."
Maximizing Tissue Capture
Because an LST is inherently flat, when the endoscopist tightens the snare, the smooth, slippery colonic mucosa actively squeezes out of the loop before the wire can grip it. 2026 standard practice mandates the utilization of specialized spiral, braided, or barbed snares for massive flat resections. The physical ridges built into the wire act as microscopic teeth, aggressively digging into the flat mucosa and physically anchoring the tissue inside the loop as it closes, allowing the endoscopist to execute a clean, deep mucosal slice through the thick submucosal injection cushion.
Clinical guidelines summarized by the Gastroscholar Research Team. Last updated: 2026. This article is intended for physicians.
For your teaching file
Save this article as a PDF
Drop your email and we'll open a print-ready version you can save as a PDF — and you'll start getting our weekly GI endoscopy newsletter.