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En-Bloc Resection of a 5 cm Flat Ascending Colonic Lesion with Endoscopic Submucosal Dissection Combined with Laparoscopy
Emre Gorgun, Cigdem Benlice^*, Feza H. Remzi
Cleveland Clinic, Cleveland, OH

This video shows the use of combined endoscopic submucosal dissection with laparoscopy to resect a large colonic lesion. Patient is a 35-year-old female with a history of ulcerative colitis underwent colonoscopy. A 5 cm flat lesion was identified at the ascending colon (tubular adenoma). After submucosal injection, incision was made with endoscopic Dual knife. Polyp was resected. Following external laparoscopic compression, no serosal defect was identified;however, dissected area was thinned out.Therefore, omental patch was created. Pathology revealed tubular adenoma. Advanced endoscopic techniques with laparoscopy enable removal of large lesions with en-bloc fashion with preserving anatomy.

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