Title: Usefulness of the combined orthodontic rubber band and clip method for gastric
endoscopic submucosal dissection
Version: 1 Date: 31 Oct 2022
Reviewer's report:
This paper shows the usefulness of a combined orthodontic rubber band and clip technique in
ESD of early gastric neoplasms. It offers good results, but there are a few things I would like
to confirm or question.
1 )  The traction method can reduce the time for submucosal dissection. If you have data only
on the time and speed of submucosal dissection, please include them in the report.
2 )  The subanalysis shows no significant difference in the lower region or lesions larger than 2
cm. Still, if only data on the time of submucosal dissection were used, there could be a significant
difference.
3 )  There are ring traction devices for endoscopic treatment, such as MLTD (Boston Scientific)
and Traction band (Micro-tech), but what makes them particularly useful for ORBs compared
to those?
4 )  Because the stomach has a wider lumen than the large intestine, one small ring is likely to
result in more clip dropouts due to air delivery. In this paper, clips dropped out in two cases.
What were the sites of those lesions? Is there a difference in the ease of clip dropout depending
on the location of the lesion?
5 )  Please include a photograph of an orthodontic rubber band (not attached to the lesion) in
the figure.
Title: Usefulness of the combined orthodontic rubber band and clip method for gastric
endoscopic submucosal dissection
Version: 1 Date: 31 Oct 2022
Reviewer's report:
This paper shows the usefulness of a combined orthodontic rubber band and clip technique in
ESD of early gastric neoplasms. It offers good results, but there are a few things I would like
to confirm or question.
1 )  The traction method can reduce the time for submucosal dissection. If you have data only
on the time and speed of submucosal dissection, please include them in the report.
2 )  The subanalysis shows no significant difference in the lower region or lesions larger than 2
cm. Still, if only data on the time of submucosal dissection were used, there could be a significant
difference.
3 )  There are ring traction devices for endoscopic treatment, such as MLTD (Boston Scientific)
and Traction band (Micro-tech), but what makes them particularly useful for ORBs compared
to those?
4 )  Because the stomach has a wider lumen than the large intestine, one small ring is likely to
result in more clip dropouts due to air delivery. In this paper, clips dropped out in two cases.
What were the sites of those lesions? Is there a difference in the ease of clip dropout depending
on the location of the lesion?
5 )  Please include a photograph of an orthodontic rubber band (not attached to the lesion) in
the figure.
Please review this paper.
user
Title: Usefulness of the combined orthodontic rubber band and clip method for gastric
endoscopic submucosal dissection
Version: 1 Date: 31 Oct 2022
Reviewer's report:
This paper shows the usefulness of a combined orthodontic rubber band and clip technique in
ESD of early gastric neoplasms. It offers good results, but there are a few things I would like
to confirm or question.
1 )  The traction method can reduce the time for submucosal dissection. If you have data only
on the time and speed of submucosal dissection, please include them in the report.
2 )  The subanalysis shows no significant difference in the lower region or lesions larger than 2
cm. Still, if only data on the time of submucosal dissection were used, there could be a significant
difference.
3 )  There are ring traction devices for endoscopic treatment, such as MLTD (Boston Scientific)
and Traction band (Micro-tech), but what makes them particularly useful for ORBs compared
to those?
4 )  Because the stomach has a wider lumen than the large intestine, one small ring is likely to
result in more clip dropouts due to air delivery. In this paper, clips dropped out in two cases.
What were the sites of those lesions? Is there a difference in the ease of clip dropout depending
on the location of the lesion?
5 )  Please include a photograph of an orthodontic rubber band (not attached to the lesion) in
the figure.
assistant