Endoscopic submucosal dissection of a rectal carcinoid tumor using grasping type scissors forceps.
Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the inability to fix the knife to the target lesion, and compression of the lesion. These can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (GSF), which can grasp and incise the targeted tissue using electrosurgical current. Colonoscopy on a 55-year-old woman revealed a 10-mm rectal submucosal nodule. The histological diagnosis of the specimen obtained by biopsy was carcinoid tumor. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. It was safely and accurately resected without unexpected incision by ESD using a GSF. No delayed hemorrhage or perforation occurred. Histological examination confirmed the carcinoid tumor was completely excised with negative resection margin.
Department of Gastroenterology, Aso Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan. kakahoshi2@aol.com
Kazuya
K
Akahoshi
Yasuaki
Y
Motomura
Masaru
M
Kubokawa
Noriaki
N
Matsui
Manami
M
Oda
Risa
R
Okamoto
Shingo
S
Endo
Naomi
N
Higuchi
Yumi
Y
Kashiwabara
Masafumi
M
Oya
Hidefumi
H
Akahane
Haruo
H
Akiba
D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000295:instrumentation; D004724:Endoscopy / Q000379:methods; D004867:Equipment Design / Q000295:instrumentation; D004869:Equipment Safety / Q000295:instrumentation; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D013525:Surgical Instruments