Deep colonic endoscopic submucosal dissection using a modified clip and snare method incorporating a pre-looping...

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic submucosal dissection (ESD) for colorectal cancer presents technical challenges compared to gastric cancer.
• Traction-assisted visualization of the submucosal layer is crucial for improving ESD outcomes.

Observation:

• A 57-year-old male presented with a 25mm laterally spreading cecal lesion (LST-GM).
• A modified clip and snare method, originally developed for gastric ESD, was adapted with a pre-looping technique for deep colonic application.

Findings:

• The modified deep colonic ESD procedure was completed successfully in 40 minutes.
• The technique resulted in no intra- or post-procedural complications.

Implications:

• This modified clip and snare technique with pre-looping facilitates deep colonic ESD.
• The approach shows promise for broader application in treating colorectal tumors via endoscopy.