2025 Volume 67 Issue 3 Pages 233-239
A 76-year-old woman was diagnosed with multiple colonic tumors via colonoscopy. However, owing to a redundant colon, cecal intubation could not be achieved at the previous hospital. The patient was subsequently referred to our hospital. We attempted by endoscopic treatment using a single-balloon overtube, but despite this assistance, scope insertion was limited to the sigmoid colon. Consequently, we performed EMR/ESD on lesions located in the sigmoid colon. For the proximal colon lesions, we switched to using double-balloon endoscopy (DBE). Using DBE, ESD was successfully performed on three lesions in the ascending and transverse colon. A protruded lesion, 30-mm diameter, was observed in the hepatic flexure and was accessible by DBE; however, it was challenging to treat endoscopically because of extremely poor scope maneuverability. We opted for a motorized spiral endoscope to approach the hepatic flexure lesion. The motorized spiral endoscope significantly improved scope maneuverability, allowing en bloc resection of the lesion. Histopathological analysis confirmed the diagnosis of adenocarcinoma (tub1) arising from adenoma, with findings of pTis, Ly0, V0, pHM0, and pVM0.
