We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.
  • 420
  • 2020-01-27

Endoscopic Submucosal Dissection (ESD) of the rectum for a large rectal polypoid lesion: a live educational procedure

Epublication WebSurg.com, Jan 2020;20(01). URL:
You must be logged in to ask a question to authors. Click here to access your account, or here to register for free!
Endoscopic Submucosal Dissection (ESD) is an endoscopic technique which allows ‘en bloc’ resection of early stage tumors and polyps in the gastrointestinal tract. In this case, Professor Yahagi presents the case of a 67-year-old male patient with an incidental finding of a large rectal polyp during an MRI study. Colonoscopy revealed a 5cm laterally spreading tumor granular type (LST-G) of the rectum, extending to one fourth of the rectal circumference. The ESD was performed with a dual channel gastroscope in retrovision due to the proximity of the LST-G to the anal verge. Glycerol and indigo carmine were injected into the submucosal plane to lift the target lesion. The mucosal incision followed by submucosal dissection was performed with a 1.5mm DualKnife™ (Olympus) using a swift coag electrosurgical setting. Hemostasis of large vessels was performed switching to the forced coag effect. The vascular submucosal network has been carefully assessed. All critical steps are evaluated during the procedure.