Endoscopic Submucosal Dissection (ESD) - Polyp Resection Techniques Technique: • The polyp is then lifted by submucosal injection, followed by incision around a lateral margin of the polyp, with dissection along the submucosal layer using a dedicated electrocautery enhanced knife to remove the polyp en bloc. Indications: • En bloc resection for high-risk lesions especially ≥20mm Limitations: • Effectiveness in dissecting non-lifting polyps with submucosal scarring • Highly operator dependent, technically challenging, requires special training, and lengthy • Much higher rates of perforation and bleeding • Cost may be higher due to longer procedure time, cost of devices, and cost of closure of defect Dr. Enrik Aguila @enrrikke #Endoscopic #Submucosal #Dissection #ESD #Polyp #Resection #Management #gastroenterology
