Incision Technique for Flattening the Elevated Mucosa due to Excess Local Injection During Colorectal Endoscopic Submucosal Dissection

Abstract

Local submucosal injection with a long-lasting solution, such as glycerol or sodium hyaluronate, is crucial for colorectal endoscopic submucosal dissection (ESD). 1-3 However, local injection fluids in lesions with severe fibrosis or deep submucosal invasion tend to spread to the submucosal layer surrounding the tumor instead of being restricted to the tumor. 4 In such situations, the submucosal layer of the tumor is difficult to visualize and approach.