ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD) IN THE WESTERN SETTING – IS TUNNELING TECHNIQUE THE WAY FORWARD ?

Since the advent of Peroral Endoscopic Myotomy (POEMS), tunneling technique has become a popular way of performing ESD.

After initial distal dissection, proximal end of the lesion is approached,creating a submucosal tunnel. The tunnel wall is then collapsed to remove the lesion. Data from a tertiary referral centre is depicted in [Table 1], demonstrating tunneling technique is a safe, effective and efficient way to perform ESD, specially in Western settings.

Tab. 1

	Average size (cm square)	Mean duration (min)	En- bloc resection	Complications
Oesophageal (N = 15)	17	99	100%	Bleeding- 0	Perforation- 0
Colorectal (N = 9)	36	221	100%	Bleeding- 0	Perforation- 0