[Endoscopic full-thickness resection (EFTR) of a symptomatic submucosal lesion in the terminal ileum using the...

Endoscopic full-thickness resection (EFTR) with the full-thickness resection device (FTRD) is established for the use in the colon and rectum, offering an effective method for the complete resection of submucosal lesions, e.g. We present the case of a symptomatic 36-year-old patient who was referred to our clinic for an ileocecal resection after a submucosal lesion in the terminal ileum was detected during an external ileocolonoscopy. Prior to the originally planned surgery, our surgical colleagues requested an ileocolonoscopy in domo for precise characterization and endoluminal marking. This confirmed a 15 mm partially lumen-obstructing submucosal lesion in the terminal ileum. The lesion was presented to the surgical team and could be well positioned within the FTRD prOVE Cap. An interdisciplinary consensus for EFTR was reached, which was performed successfully after careful preparation with coagulation marking. Histopathological examination of the full-thickness resection specimen revealed a large lipoma without evidence of malignancy. Although navigating the right hemicolon and ileocecal valve with the FTRD can be challenging, EFTR represents an elegant option for oncologically exact endoluminal resection in selected cases, even in the terminal ileum.