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Endoscopic submucosal dissection (ESD) is an advanced surgical procedure using endoscopy to remove gastrointestinal tumors that have not entered the muscle layer. ESD may be done in the esophagus, stomach or colon. Application of endoscopic resection (ER) to gastrointestinal (GI) neoplasms is limited to lesions with no risk of nodal metastasis.
Endoscopic mucosal resection and submucosal dissection are also highly effective methods for resection or large, non-malignant colorectal polyps and superficially (stage T1a) invasive colorectal cancers. The largest study of endoscopic mucosal resection by the Australian Consortium included 1000 cases and long term surveillance. [2]
This procedure uses high frequency monopolar current directed by ionised argon gas to coagulate tissues and mucosal ulcers, aiming to promote healing through re-epithelializion. [ 6 ] Sclerotherapy : injection into the submucosal layer or retro rectal space with 5% phenol, 30% hypertonic saline or 25% glucose and perianal cerclage .
The colon is then mobilized from the retroperitoneum. Care is taken to avoid injury to the ureters and duodenum. The surgery then follows the same steps as small bowel resection. However, due to the colon's placement in the retroperitoneum, more dissection is often required to allow for tension free anastomosis. [5] [6]
Colonic polypectomy is the removal of colorectal polyps in order to prevent them from turning cancerous.. Method of removing a polyp with a snare. Gastrointestinal polyps can be removed endoscopically through colonoscopy or esophagogastroduodenoscopy, or surgically if the polyp is too large to be removed endoscopically.
Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique whereby "scarless" abdominal operations can be performed with an endoscope passed through a natural orifice (mouth, urethra, anus, vagina, etc.) then through an internal incision in the stomach, vagina, bladder or colon, thus avoiding any external incisions or scars.
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Eponymous surgical procedures are generally named after the surgeon or surgeons who performed or reported them first. In some instances they are named after the surgeon who popularised them or refined existing procedures, and occasionally are named after the patient who first underwent the procedure.