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Underwater endoscopic resection: an alternative for difficult colorectal polyps.

Dalton Marques Chaves1,2, Hélcio Pedrosa Brito1, Lumi Tomishige Chaves3

  • 1Fleury Medicine and Health, São Paulo, Brazil.

Videogie : an Official Video Journal of the American Society for Gastrointestinal Endoscopy
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Summary

Underwater endoscopic resection effectively removes difficult colorectal polyps. This technique offers a safe alternative for large or complex polyp removal, demonstrating successful outcomes in four cases.

Keywords:
LST, laterally spreading tumor

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Colorectal Surgery

Background:

  • Standard endoscopic resection can be challenging for large or difficult colorectal polyps.
  • Underwater endoscopic resection (UER) presents an alternative approach.

Purpose of the Study:

  • To demonstrate the feasibility and efficacy of UER for large colorectal polyps.
  • To present four case studies of UER for challenging polyp removal.

Main Methods:

  • UER involves filling the colon lumen with fluid via an infusion pump.
  • Polyps are then resected using a snare, with various snare types employed.
  • Four cases included large laterally spreading tumors and pedunculated polyps in different rectal and sigmoid locations.

Main Results:

  • All four large colorectal polyps were successfully resected using the underwater technique.
  • No adverse events were reported during or after the procedures.
  • Follow-up examinations confirmed no residual polyp tissue.

Conclusions:

  • Underwater endoscopic resection is a viable and effective alternative to standard techniques for difficult colorectal polyps.
  • The technique facilitates safe and complete removal of large and complex colorectal lesions.