ESD of a large rectal lesion by use of a novel tissue retractor system

SalmaanPost written by Salmaan Jawaid, MD, from the Division of Gastroenterology and Hepatology, University of Florida, Gainesville, Florida, USA.

We presented a case of successful endoscopic submucosal dissection of a large rectal lesion using a novel tissue retractor system. This unique platform allowed us to generate constant tissue tension and permitted frequent manipulation of the tissue in multiple axis while maintaining our location within the dissection field. The lesion was resected within a reasonable amount of time, and the patient had no immediate adverse events. Pathology revealed tubulovillous adenoma with focal serrated feature, and lateral and vertical margins were free of cancer.

A key component to successful and efficient submucosal dissection is being able to provide adequate tissue tension in order to easily visualize the dissection plane. Current modalities used to exert tissue tension are only moderately effective in providing adequate traction and typically only allow tissue manipulation along one axis. This novel tissue retractor system allows the operator to provide constant tissue traction and targeted manipulation of the lesion without losing position of the operative field. Although effective, initial use of the tissue retractor system can seem overwhelming for the first-time operator. Demonstrating its use can hopefully minimize any hesitancy and decrease the learning curve.

The advent of newer tissue retractor systems provides the endoscopist with an additional method to maintain optimal visualization of the dissection plane and allows for safe and efficient ESD of very large lesions within the colon.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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