| Theme |
Towards Standardization of ESD Procedures |
| Title |
Pocket—creation Method (PCM) of Colorectal ESD |
| Author |
Yoshikazu Hayashi |
Department of Medicine, Division of Gastroenterology, Jichi Medical University |
| Author |
Hironori Yamamoto |
Department of Medicine, Division of Gastroenterology, Jichi Medical University |
| [ Summary ] |
The pocket‒creation method (PCM) achieves safe and reliable colorectal endoscopic submucosal dissection (ESD). Two advantages of PCM include "good tractions" and "high‒quality resected specimen". The first advantage involves good traction and counter‒traction to stretch the submucosal tissue to be dissected, provided by simple insertion of a small‒caliber‒tip transparent hood with an endoscope into the submucosal pocket. The second advantage is that submucosal dissection is achieved just above the muscularis propria, which contributes to a high‒quality resected specimen with a thick and little thermal‒damaged submucosal tissue, appropriate for pathological diagnosis. Moreover, the submucosal dissection by visual observation can keep the muscularis propria from unintentional damage. In addition, there are many advantages of PCM including stabilization of endoscopic maneuverability inside of the pocket. We would highly recommend learning PCM as a standard ESD strategy. |