SUBMUCOSAL TUNNELLING ENDOSCOPIC RESECTION (STER) OF A RECTAL LEIOMYOMA

A 45-year-old male patient performed colonoscopy for abdominal pain. A rectal subepithelial lesion of 10 mm was identified and further characterized with endoscopic ultrasound as an hypoechogenic homogeneous well-defined lesion of the second layer, measuring 9.1x10.8 mm. Considering the diagnostic possibility of gastrointestinal stromal tumour, the lesion was resected using a submucosal tunnelling endoscopic resection technique. A 20 mm incision was made under the lesion, after submucosal injection. A submucosal tunnel was created dissecting the submucosal fibers and exposing the lesion. En bloc resection of the lesion was then performed. Finally, the incision was closed using hemostatic clips.