What is ESD?

           Endoscopic submucosal dissection (ESD)


Endoscopic submucosal dissection is a minimally invasive advanced endoscopic procedure which is used to remove or resect pre-cancerous or early cancerous lesions of the gastrointestinal tract (GI). 




The upper-most lining of the GI tract is the mucosa and layer below it is the submucosa. Lesions or masses originating from this layer can be managed only with this procedure. The procedure uses an electrical current based ’surgical knife’ to remove the mass. Any minor bleeding is also cauterized and the entire mass is resected under real-time visualization. 

Indications: -

1. Early cancers or micro invasive cancers of the upper gastrointestinal tract like            esophagus, stomach or duodenum 
2. Masses or polyps in the lower gastrointestinal tract, especially neoplastic polyps 
3. Pre-cancerous lesions like Barrett’s esophagus


Advantages of ESD over surgery 

1. Minimally invasive procedure 
2. Complete resection prevents spread of cancer
3. Accurate staging and grading
4. Minimal stay in the hospital (1-2 days max) 
5. No complications 6. Excellent prognosis


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