Review for 10.1186/s12876-021-02085-w (2022)

Reviewer’s report
Title: 
Multi-loop traction device facilitates gastric endoscopic submucosal
dissection: ex vivo pilot study and an inaugural clinical experience
Version: 
0 
Date: 
13 Sep 2021
Reviewer's report:
This study is interesting and well written. New equipment, MLTD looks simple
and easy to use. 
1. The sample size of ESD using MLTD is 11 out of 10 patients without control.
Comparing with historical control (consecutive or propensity score matched
control) may help readers understand easily benefit of MLTD-ESD compared to
conventional method. Comparison of total time consumed including applying
and retrieval time versus C-ESD is needed. I think total number of the procedure
can be added to primary endpoint. 
2. The velocity of submucosal dissection is 4 fold faster in M-ESD group than in
C-ESD group. (141.5 vs 35.5 mm2/min). The velocity of C-ESD was much
slower than anticipated (your assuming velocity is 0.6cm2/min). Authors may
address this issue in the discussion section. 
3. Present IRB approval for ESD using MLTD. MLTD is newly-developed
"inaugural" medical equipment and thus there is an ethical issue when it is firstly
introduced to a patient. Is the IRB approval number that you presented for
retrospective study to collect already performed ESD using MLTD ? 
4. Also, ethical issues regarding animal should be presented. 
5. The MLTD is made of "low-density polyethylene plastic". Is it bio-
compatible? This needs to be added in the methods section. 
6. How was the method of MLTD retrieval? Authors'd better add it to the
methods section.
7. How was the price of the MLTD? 
8. In tables, adding porcine or human subjects to titles may be helpful to readers. 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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from apparent manipulation?
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