Combination of tunneling and traction techniques for endoscopic submucosal dissection of a laterally spreading tumor in a ulcerative colitis patient

Abstract Text A 56 years old ulcerative colitis patient, diagnosed with 50 mm Laterally Spreading Tumour – non Granular type in the descending colon, was scheduled for endoscopic submucosal dissection. Submucosal injection provided only a modest lifting of the lesion. After a partial mucosal incision on the anal side of the lesion with an electrosurgical knife, a submucosal tunnel up to the oral side was created. Afterwards a complete circumferential mucosal incision was performed. Submucosal dissection however was impaired by severe fibrosis, linked to chronic mucosal injury(1). Thus, the mucosal flap was tractionated using a clip and a rubber band to anchor it to the contralateral wall of the bowel. Afterward, the dissection plane was distinctly visible and submucosal dissection was carried out until "en-bloc" detachment of the lesion.

Video http://data.process.y-congress.com/ScientificProcess/Data//106/474/1197/de89680b-a05e-4b0e-b0c5-ec9f0b7e3462/Uploads/13821_ESD_RCU%20Esge.mp4

Publication History

Article published online:
15 April 2024