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Related Concept Videos

Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Related Experiment Video

Updated: May 2, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
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[Problem of standardization in colorectal ESD].

Shinji Nagata1, Daiki Hirano1

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Endoscopic submucosal dissection (ESD) allows detailed pathology for large colorectal tumors, surpassing endoscopic mucosal resection (EMR). Despite technical challenges and higher complication risks, colorectal ESD is improving with procedural innovations and better devices.

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Oncology

Context:

  • Endoscopic submucosal dissection (ESD) offers advanced pathological examination for large colorectal tumors.
  • Traditional endoscopic mucosal resection (EMR) has limitations for large or complex lesions.

Purpose:

  • To evaluate the efficacy and challenges of colorectal endoscopic submucosal dissection (ESD).
  • To highlight the advancements and ongoing standardization issues in colorectal ESD procedures.

Summary:

  • Colorectal ESD enables detailed analysis of large tumors previously difficult to manage with EMR.
  • Technical difficulties include fibrosis, submucosal access, lesion confrontation, endoscope operability, and physiological variations (heartbeat, respiration).
  • Despite initial challenges and higher complication rates than EMR, colorectal ESD is becoming safer through procedural ingenuity and improved endoscopic devices.

Impact:

  • Colorectal ESD is enhancing diagnostic accuracy for complex colorectal tumors.
  • Standardization of colorectal ESD is progressing, aiming to mitigate technical difficulties and improve patient outcomes.