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DOI: 10.1055/a-2261-7532
Mucosal snare resection-endoscopic submucosal excavation: a novel technology
Endoscopic submucosal excavation (ESE) is a less invasive therapeutic alternative to surgical resection for the removal of gastric submucosal tumors [1]. The conventional procedural steps of this technique all involve cautery markings to delineate the target lesion, followed by submucosal injection and the resection of the lesion using a hook knife, insulation-tipped knife, or dual knife, and finally, closure of the mucosal incision using clips [2]. We report a novel variant ESE technique, mucosal snare resection-endoscopic submucosal excavation (MSR-ESE), for a lower technical burden and shorter procedure time compared with ESE.
MSR-ESE was successfully carried out as follows. First, the surface mucosa of the lesion was enclosed by the snare and electrocoagulation excision was performed without prior submucosal injection ([Fig. 1]). With gradual exposure, the lesion was completely dissected along its edge and above the muscularis propria by an insulation-tipped knife ([Fig. 2]). After complete resection and retrieval of the lesion, the mucosal incision was closed tightly by metal clips ([Fig. 3]). The total operation time was 18 minutes, and no bleeding or perforation complications occurred ([Fig. 4], [Video 1]).
Quality:
MSR-ESE eliminates the need for electrocoagulation marking and submucosal injection. Our department has performed more than 10 cases successfully. Thus, in the future, MSR-ESE may be considered a safe, time-saving, and effective option for submucosal tumors.
Endoscopy_UCTN_Code_TTT_1AQ_2AC
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Publication History
Article published online:
22 February 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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References
- 1 Li B, Chen T, Qi ZP. et al. Efficacy and safety of endoscopic resection for small submucosal tumors originating from the muscularis propria layer in the gastric fundus. Surg Endosc 2019; 33: 2553-2561
- 2 Cheng BQ, Du C, Li HK. et al. Endoscopic resection of gastrointestinal stromal tumors. J Dig Dis 2023; DOI: 10.1111/1751-2980.13217.