| Theme |
Aims to improve colorectal ESD safety and efficiency |
| Title |
Achieving safe and effective colorectal endoscopic submucosal dissection (ESD) in the technically challenging colon |
| 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 ] |
Good endoscopic maneuverability and stability are essential for the performance of safe and effective colorectal endoscopic submucosal dissection (ESD). However, in certain circumstances increased mobility of the colon may result in endoscopic instability and diminished colonoscope tip control. Maintaining a straight instrument with effective tip control is difficult to achieve in the presence of a dolichocolon or abdomino-pelvic post-surgical adhesions for example. A countermeasure which the colonoscopist often applies in such situation is to change patient position, in an attempt to use gravity to improve endoscopic control. If this maneuver is ineffective, intentional loop formation by gentle colonic stretching may improve stability. Nevertheless, despite the adoption of these ancillary techniques, conventional colonoscopy may still fail to achieve the desired degree of endoscopic control. The intrinsic design of balloon-assisted endoscopy (BAE) enhances endoscopic maneuverability and provides the operator with a more effective alternative to conventional colonoscopy in such circumstances. |