Ahmed Sharata, MD1, Christy Dunst, MD1, Marc Ward, MD2, Ezra Teitelbaum, MD2, Kevin Reavis, MD1, Steven DeMeester, MD1, Lee Swanstrom, MD1. 1Oregon Clinic/GMIS, 2Portland Providence Cancer Center
Background: Colorectal endoscopic submucosal dissection (ESD) techniques have been increasingly reported in the Eastern world while its use is limited in the Western world. The superiority of the ESD comparing to Endoscopic mucosal resection (ERM) is to remove the lesion en-bloc. While evaluation of margins remains a benefit, technical difficulty and full-thickness perforation remain a major problem. Endoscopic traction and over-the-scope suturing may be helpful in overcoming the technical difficulty and repairing the perforation when it exists. We present a video of sigmoid ESD with endoscopic traction technique and endoscopic suturing of the musical defect.
Method: A sessile polyp at the sigmoid colon is resected endoscopically using ESD with endoscopic suture traction technique. An over-the-scope suturing in figure of 8 technique used to close the mucosal defect as shown.
Conclusion: An endoscopic submucosal dissection is feasible for colorectal neoplasm, but with technical challenges and high rate of perforation. The endoscopic suture traction technique with over-the-scope suturing of the mucosal defect represents a potential solution.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79899
Program Number: V071
Presentation Session: Endoscopy Video Session
Presentation Type: Video