Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure

摘要

A 60-year-old man with a history of adenomatous colon polyps presented to our institution for surveillance colo- noscopy. Initial colonoscopy revealed a carpet-like, 40- mm, laterally spreading tumor granular type lesion in the sigmoid colon on high-definition white-light endos- copy (Fig. 1A). Further examination of the lesion via image-enhanced endoscopy with blue light imaging and chromoendoscopy with indigo carmine revealed a Japan NBI Expert Team Type 2A lesion and Kudo type IV pit pattern, respectively (Fig. 1B and C). 1-3 Given the size, location, and noninvasive pattern, the decision was made to perform hybrid endoscopic submucosal dissec- tion (ESD) with a novel ESD knife, followed by mucosal defect closure using an innovative endoscopic helix tack- ing system.