Endoscopic submucosal dissection with reinforcement using a laparoscopic approach for a duodenal cavernous hemangioma

Post written by Yoriaki Komeda, MD, PhD, from the Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.

Komeda_photo

We performed endoscopic submucosal dissection (ESD) with reinforcement using a laparoscopic approach (duodenal-laparoscopic and endoscopic coordinated surgery [D-LECS] with ESD) for a duodenal cavernous hemangioma.

Cavernous hemangiomas including duodenum are derived from the submucosa. Even minimally invasive endoscopic procedures—such as polyp resection, EMR, and argon plasma coagulation—may cause heavy bleeding or perforation.

Although laparoscopic resection is reportedly useful for duodenal lesions, it is highly invasive and associated with difficulty in identifying the exact tumor location. 

This technique for a duodenal cavernous hemangioma has been reported to facilitate postexcisional suturing and reduce the risk of perforation.

Other endoscopists can learn a safer technique of ESD with reinforcement using a laparoscopic approach (D-LECS with ESD) for a duodenal cavernous hemangioma >1 cm.

Komeda_figureEndoscopic image of a cavernous hemangioma in the third portion of the duodenum.

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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