Removal of large polyps in one piece
(Endoscopic submucosal dissection - ESD)Endoscopic submucosal dissection (ESD) is a special endoscopic technique developed in Japan. It can be used to remove advanced polyps or early tumors in the esophagus, stomach or colon. In contrast to endoscopic mucosal resection (EMR), large findings can also be removed in one piece.
Before removal, the edges of the tumor or polyp are first marked. The affected area is then cut around with a special endoscopic knife. In the next step, the mucous membrane, the mucosa, is injected with a saline solution. This causes it to separate from the underlying, non-diseased tissue layer, the submucosa. The diseased areas of the mucosa can now be removed.
ESD is technically very complex. A procedure can therefore take two to three hours, depending on the size and location of the findings. For this reason, many procedures are performed under anesthesia with a breathing tube and, of course, under inpatient conditions. The technique also requires a certain amount of experience and is therefore only carried out by qualified specialists.