Cap-suction pseudopolyp formation during underwater mucosal resection for intra-appendiceal lesions

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Intra-appendiceal lesions present management challenges.
• Endoscopic resection is a potential treatment modality.

Purpose of the Study:

• To provide technical insights for cap-suction pseudopolyp formation.
• To detail its application in underwater endoscopic mucosal resection for intra-appendiceal lesions.

Main Methods:

• Two cases of asymptomatic intra-appendiceal lesions were treated.
• Procedures involved deep sedation, cap-assisted colonoscopy, and underwater endoscopic mucosal resection.
• Saline infusion and cap-suction were used to create pseudopolyp formation for lesion invagination and snare resection.

Main Results:

• Successful endoscopic resection of two intra-appendiceal lesions.
• No intraprocedural or delayed adverse events were observed.
• Histology confirmed sessile serrated lesions with complete (R0) resection.

Conclusions:

• Cap-suction pseudopolyp formation is a feasible and useful technique.
• It facilitates endoscopic management of intra-appendiceal lesions.
• This approach offers a safe alternative for specific lesion types.