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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

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.
During an EGD, the endoscope can be used to:
Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

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:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...

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Related Experiment Video

Updated: Jul 14, 2026

Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
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Gel-immersion Endoscopic Submucosal Dissection for Superficial Colorectal Neoplasms: A Retrospective Study Comparing

Kenji Yamauchi1, Tomoki Inaba1, Takeshi Morimoto2

  • 1Department of Gastroenterology Kagawa Prefectural Central Hospital Kagawa Japan.

DEN Open
|October 13, 2025
PubMed
Summary

Gel-immersion endoscopic submucosal dissection (Gi-ESD) offers a clear view without gas for colorectal lesions. This technique showed a higher histologic R0 resection rate, proving useful for difficult cases.

Keywords:
colon neoplasmsendoscopic mucosal resectionendoscopic surgerygravitationimmersion

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Colorectal Cancer Treatment

Background:

  • Gel-immersion endoscopy (GIE) provides buoyancy, traction, and a clear visual field, avoiding gas insufflation.
  • While case reports exist, consecutive series on colorectal gel-immersion endoscopic submucosal dissection (Gi-ESD) are lacking.
  • Clarifying the utility of Gi-ESD in a consecutive series is crucial.

Purpose of the Study:

  • To evaluate the usefulness of Gi-ESD for colorectal neoplasms.
  • To compare Gi-ESD with conventional endoscopic submucosal dissection (ESD).

Main Methods:

  • A single-center retrospective cohort study of consecutive patients undergoing colorectal ESD.
  • Gi-ESD involved mucosal incision and submucosal dissection under clear gel.
  • Primary outcomes: en bloc and histologic R0 resection rates. Secondary outcomes: procedure time, dissection speed, adverse events.

Main Results:

  • The Gi-ESD group (29 patients) had larger tumors, more cecal/ascending colon lesions, and higher difficulty factors than the conventional ESD group (231 patients).
  • No significant differences in en bloc resection or adverse events.
  • Histologic R0 resection was 96.6% for Gi-ESD vs. 88.7% for conventional ESD (p=0.045 in propensity score-matched cohort).
  • Procedure time was longer for Gi-ESD (45 min vs. 29.5 min).

Conclusions:

  • Gi-ESD is a viable alternative for submerged or difficult-to-access colorectal lesions.
  • The technique demonstrated comparable en bloc resection and safety profiles to conventional ESD.
  • Gi-ESD achieved a significantly higher histologic R0 resection rate in challenging cases.