Removal of a Large Rectal Lesion with Endoscopic Submucosal Dissection Using a New Endoluminal Platform

Ipek Sapci, MD; Emre Gorgun, MD, FACS, FASCRS

Product Details
Product ID: ACS-5929
Year Produced: 2019
Length: 5 min.


Endoscopic submucosal dissection can be technically challenging and innovative platforms that enable stabilization and tissue retraction can assist with this demanding technique. Here we present removal of a large rectal lesion with endoscopic submucosal dissection using a new endoluminal platform. The patient is a 46-year-old male found to have a 65 mm polyp in the rectum extending proximally which was not amenable for conventional endoscopic removal. He was referred to our center for endoscopic submucosal dissection. The colonoscope was introduced and the lesion was located. The solution was injected into the submucosal space and dissection with dual knife was started and continued along the borders of the lesion circumferentially ensuring negative gross margins. After the horseshoe shaped dissection into submucosal plane was performed for several millimeters, the platform was introduced. The platform was positioned at the level of the lesion and was manipulated to allow stabilization of the lumen. Tissue grasper was introduced and was used to grasp and retract the tissue therefore assisting in submucosal dissection. Subsequently, the dissection assisted by the platform was completed with en-bloc removal of the lesion and here you can appreciate the resection site. 3 hemostatic clips were applied at the end of the procedure and the patient was discharged home on the same day with no complications. New platforms that enable application of surgical principles such as lumen stabilization and tissue retraction, can refine endoluminal surgery and carry it a step further, resulting in more precise dissections and improved proficiency.