| Theme | Endoscopic treatment of early colorectal cancer and adenoma -- the advancement of EMR and ESD technique | |
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| Title | Endoscopic submucosal dissection (ESD) using double balloon endoscopy (DBE-ESD) | |
| Publish Date | 2007/11 | |
| Author | Keijiro Sunada | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Tomohiko Miyata | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Michiko Iwamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Tomonori Yano | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Masayuki Arashiro | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Yoshikazu Hayashi | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Hironari Ajibe | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Hiromi Fukushima | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Masato Shigemori | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Yuichi Iwashita | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| Author | Hironori Yamamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University |
| [ Summary ] | Double balloon endoscopy (DBE) was originally developed as a new technique for visualization of and intervention in the entire small intestine. It has been shown to be useful for difficult colon conditions as well. The principle of DBE is that by holding the intestinal wall with a balloon attached to the distal end of a soft overtube, the endoscope can be inserted further without intestinal extension. ESD for superficial colorectal lesions is thought to be difficult because very fine endoscopic control is needed to carry out the procedure without complications such as perforation. Using a conventional colonoscope, even an expert endoscopist may struggle to carry out ESD if the endoscope moves paradoxically. In order to facilitate this procedure, DBE was used for colorectal ESD (DBE-ESD). Using DBE, paradoxical movement is prevented even in the difficult situations within the colon. Techniques employed are described, along with a case presentation. |
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