Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, and Fateh Bazerbachi, MD, from CentraCare, St. Cloud, Minnesota, USA.

This article presents the different endoscopic modalities for resecting gastric subepithelial lesions (SELs) including:

• Submucosal tunneling endoscopic resection
• Full-thickness resection using the gastric full-thickness resection device
• Endoscopic submucosal dissection
• Exposed endoscopic full-thickness resection
• Laparoscopic endoscopic cooperative surgery  

Successful en bloc resection of gastric SELs was achieved in all patients without adverse events.

This video illustrates, through clinical examples, choosing the appropriate resection method based on endoscopic and endosonographic evaluation of the tumor and patient anatomical factors. It also provides technical tips for these techniques.

A thorough endoscopic, endosonographic, and—in select cases—cross-sectional imaging evaluation is a sine qua non for planning endoscopic resection of a gastric SEL.

Successful endoscopic resection of gastric SELs requires acquaintance with the tips and tricks of the different resection techniques. Safe endoscopic resection of gastric SELs necessitates proficiency in closure techniques and percutaneous abdominal decompression. It also demands a multidisciplinary approach and surgical support.

Patient 3. A, Endoscopic view of the gastric subepithelial lesion. B, Endosonographic view of the subepithelial lesion bordering the splenic hilar vessels. C, Traction to create tension on the tumor attachments and pull the tumor away from the splenic hilum. D, View after closing the full-thickness defect with endoscopic suturing.

Read the full article online.

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