How to Learn and Perform Endoscopic Submucosal Dissection and Full-Thickness Resection in the Colorectum in the United States

Pioneered in Japan to address the limitations of endoscopic mucosal resection in the stomach, endoscopic submucosal dissection (ESD) has been applied throughout the gastrointestinal tract, including the colorectum. ESD is technically challenging and has been slowly gaining traction in the West. However, for the committed and resourceful endoscopist, proficiency in ESD can still be achieved. Moreover, improvement in techniques and devices are likely to ease the learning curve while improving procedural duration, safety, and efficacy of colorectal ESD. This article reviews challenges and methods in learning ESD in the United States and provides a primer on performing ESD and full-thickness resection in the colorectum.