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Create a Free AccountProcedures - Endoscopic submucosal dissection (ESD)
Successful endoscopic submucosal dissection for a tumor located completely within a colonic diverticulum after inversion of the diverticulum using a traction device
A 59-year-old man was diagnosed as having a flat-elevated tumor measuring 10 mm in diameter in the colon; the tumor was completely located within a colonic diverticulum in the hepatic flexure (Fig. 1A to C). Based on endoscopic evaluation, we determined there was a good chance of obtaining curative resection by endoscopic means. In addition, because we made it possible to invert the diverticulum into the colonic lumen by traction with forceps, we scheduled endoscopic submucosal dissection (ESD) using a traction device with the patient under general anesthesia (Fig. 1D).Endoscopic transcecal appendectomy under laparoscopic single-port assistance
A 72-year-old man was detected as having a flat-elevated tumor located in the appendix, measuring 15 mm in diameter (Fig. 1A). The lesion completely covered the appendiceal orifice, and the edge of the lesion could not be visualized (Fig. 1B). Because patients usually want minimally invasive treatments, endoscopic transcecal appendectomy was scheduled after the patient provided informed consent. It is our strategy to use a single port to introduce the laparoscope and confirm the condition around the appendix, to guide the endoscope safely, and to endoscopically resect the lesion and close the defect.Continuous saliva suction tube to prevent aspiration pneumonia during upper GI endoscopy
Endoscopic submucosal dissection (ESD) has been established as a minimally invasive treatment modality and has been adopted worldwide for the treatment of early GI tract cancer. However, aspiration pneumonia, a sedation-related adverse event, is reportedly detected on postoperative CT images in 32.0% of cases after esophageal ESD1 and 6.6% to 14.4% of cases after gastric ESD.2,3 Clinical symptoms in the majority of patients are often mild, but symptoms can become serious in elderly patients. Furthermore, because the number of endoscopic treatments for elderly patients is expected to continue to increase in the future, a new strategy is needed to prevent aspiration pneumonia associated with liquid reflux and saliva retention in the oral cavity.Successful endoscopic submucosal dissection for a huge lipoma in the terminal ileum
A 74-year-old man underwent a CT examination for intermittent lower abdominal pain. The images revealed a tumor in the ileocecal region (Fig. 1A). Endoscopic examination showed the lesion to be a soft, yellowish submucosal tumor measuring 40 mm in diameter located in the terminal ileum (Fig. 1B). The lesion fully occupied the lumen; it moved to the cecum when pulled but immediately returned to the ileum upon insufflation (Fig. 1C). Based on CT and endoscopic findings, we made a diagnosis of lipoma.Usefulness of a thin-endoscope endoscopic submucosal dissection using the traction device for early gastric cancer in a patient with esophageal stricture
Use of endoscopic submucosal dissection (ESD) for early gastric cancer has become widespread. However, the conventional endoscope sometimes cannot be used for reasons such as the presence of a stricture. Previously, endoscopic resection could be performed only after dilatation (eg, balloon) to treat the stricture, but this has the risk of adverse events (eg, perforation and bleeding).1 We report successful ESD for early gastric cancer using a thin endoscope.
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