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Updated: May 23, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
[Advances in surgical endoscopy: initial experience in endoscopic colonic submucosal dissection (ESD) in Costa Rica]
Sergio A Con1, Gustavo Kishimoto, Gil R Con-Chin
1Divisiones de Cirugía y Endoscopia, Centro Digestivo Drs. Con-Mediplaza, San José, Costa Rica.
Objectives:
To report the first case in Costa Rica of a colon tumor removed by endoscopic submucosal dissection (ESD).
Patient And Method:
We describe the case of a 70-year-old man with a multilobulated 25 millimeters tumor located in the cecum, near the ileocecal valve, detected during a routine colonoscopic check-up. The biopsy revealed a tubular adenoma with high grade dysplasia and the patient underwent an endoscopic submucosal en-bloc dissection of the lesion.
Results:
The procedure was successfully performed without complications such as bleeding or perforation. The operative time was 117 minutes. The histopathological analysis of the en-bloc specimen confirmed the diagnosis of high grade dysplasia with negative vertical and horizontal margins.
Conclusion:
Colon ESD is an attractive and safe treatment option for the removal of premalignant lesions and some types of early colon cancer.
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