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MANAGING POUCH POLYPS: COMBINED ENDOSCOPIC AND ENDOROBOTIC SUBMUCOSAL DISSECTION
Salih N. Karahan^*, Brogan Catalano, Mustafa Oruc, Phoenix Bell, Emre Gorgun
Colorectal Surgery, Cleveland Clinic, Cleveland, OH

We present a 47-year-old female with a history of total proctocolectomy and ileal pouch-anal anastomosis for FAP. A 5 cm laterally spreading tumor in the pouch was identified. A hybrid approach was used: the distal lesion was resected with endoscopic submucosal dissection (ESD), and the proximal portion with endorobotic submucosal dissection (ERSD). The lesion was removed en bloc, and the patient was discharged the same day without complications. Pathology revealed tubulovillous adenoma with high-grade dysplasia and negative margins. Advanced techniques like ESD and ERSD allow complete resection of complex pouch lesions, preserving function and avoiding invasive procedures.

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