Endoscopic submucosal dissection is a difficult procedure with frequent complications.
Our aim was to test the feasibility of utilizing a second endoscopic arm to improve
the dissection. An Olympus prototype blind probe, with an external diameter of 6 mm
and a 2.8-mm working channel, was used as a second endoscopic arm. Its purpose was
to lift the lesion during dissection. The main endoscope served both to perform the
dissection and to visualize the second endoscopic arm in the monitor. Eight patients
with polypoid lesions in the rectum or distal sigmoid were treated successfully. The
procedure was feasible, and submucosal exposure was ameliorated allowing easier dissection.
The resection was curative in all cases. No recurrences have been detected during
up to 18-months of follow-up. A small perforation and two cases of delayed bleeding
were managed nonsurgically. Applying counter-traction with a second endoscopic arm
can facilitate submucosal dissection of distal colorectal lesions.
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P. FusaroliMD
Department of Gastroenterology
Ospedale di Castel S. Pietro Terme
Viale Oriani 1
Castel S. Pietro Terme 40024
Bologna
Italy
Fax: +39-051-6955206
Email: p.fusaroli@ausl.imola.bo.it
