INDICATIONS AND TIPS FOR HYBRID ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLORECTAL TUMORS

Abstract

Widespread application of colonoscopy has enhanced endoscopic detection and removal of colorectal tumors. Endoscopic snare resection is a safe, effective, and time-saving procedure for removing neoplasms measuring ≤ 20 mm. Lately, ESD is being widely used as a standardized technique for the resection of lesions larger than 20 mm and those with possible submucosal fibrosis or submucosal invasion. However, ESD is a challenging procedure owing to a high risk of adverse events, technical difficulties, prolonged operative time, and high medical costs. Hybrid ESD is a recently developed technique that combines the snare resection and ESD procedures. Previously, a hybrid ESD procedure required several devices, including ESD knives and snares. Presently, a newly launched, multifunctional SOUTEN^Ⓡ device enables completion of a hybrid ESD procedure using only a single device. This device can potentially overcome drawbacks of ESD and enhance benefits of snare resection. In this article, we have outlined the technical tips and discussed the potential indications for hybrid ESD using the SOUTEN^Ⓡ device.