Post written by Natalie Wilson, MD, from the Department of Internal Medicine, University of Minnesota Medical Center, and Mohammad Bilal, MD, from the Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, and Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.
In this case, we describe the successful resection of a 15-mm partially healed gastric ulcer with persistent low-grade dysplasia in an elderly man using endoscopic full-thickness resection with a full-thickness resection device.
We chose to showcase this particular video because precancerous lesions with underlying scarring or ulceration can often be challenging to resect with conventional resection techniques. This case highlights that endoscopic full-thickness resection with the full-thickness resection device may offer a feasible alternative in such cases.
In lesions with significant scarring or ulceration, using judicious, intermittent suction while applying constant backward tension on the grasping forceps to completely pull the lesion into the full-thickness resection device cap can help with resection with negative resection margins. Suction should be used cautiously.
However, when using a single-channel scope, the presence of grasping forceps in the endoscope itself limits the amount of suction that can be applied.
Initial upper endoscopy showing antral gastric ulcer.
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