Theme |
Aims to improve colorectal ESD safety and efficiency |
Title |
How to dissect the submucosal layer safely when you face the proper muscle layer |
Author |
Hiroshi Kashida |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Toshiharu Sakurai |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Yutaka Asakuma |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Masanori Kawasaki |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Tomoyuki Nagai |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Yoshiaki Nagata |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Masaki Takayama |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Hiromasa Mine |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
Author |
Teppei Adachi |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
[ Summary ] |
When performing colorectal ESD, physicians must be careful when they face the proper muscle layer, in locations such as the cecum or the lower rectum. Care must also be taken when encountering lesions lying over a high fold or at a flexure. Management techniques for overcoming this problem include the following : 1. adequate amounts of injected solutions and sufficient distances between the lesion's boundary and the line of circumferential incision, 2. use of attachments, 3. rotation of the scope, 4. posture changes and 5. use of clips. Retroflex motion of the scope may work depending on the location of the lesion. |