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. 2025 Feb 3;10(6):289-295.
doi: 10.1016/j.vgie.2025.01.010. eCollection 2025 Jun.

Challenges and solutions in endoscopic full-thickness resection

Fatih Aslan  1 , Serhat Ozer  1 , Orhun Cig Taskin  2 , Akın Akbulut  3
Affiliations

Challenges and solutions in endoscopic full-thickness resection

Fatih Aslan et al. VideoGIE. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

All authors disclosed no financial relationships.

Figures

Figure 1
Figure 1
The endoscopic appearance of a subepithelial lesion.
Figure 2
Figure 2
The endoscopic appearance of a circumferential mucosal incision and dissection.
Figure 3
Figure 3
Schematic view of the snare is advanced to the procedure area by being passed outside the endoscope.
Figure 4
Figure 4
Schematic view of the snare is fixed to the lesion with 1 hemostatic clip.
Figure 5
Figure 5
Schematic view of the snare is closed and retracted.
Figure 6
Figure 6
Carbon dioxide passing from the defect area into the intra-abdominal cavity.
Figure 7
Figure 7
The snare is fixed to the lesion with a clip.
Figure 8
Figure 8
The lesion is retracted using the snare.
Figure 9
Figure 9
Materials required for the handmade balloon-valve: spray catheter (Olympus, Tokyo, Japan), sterile rubber glove, tape, suture thread, syringe, syringe valve, scissors.
Figure 10
Figure 10
Appearance of the 2-cm section cut from the finger part of the sterile glove, tied to the distal part of the spray catheter with a suture.
Figure 11
Figure 11
Taping over the suture to prevent air leakage from the distal end and placing a valve and syringe on the proximal part of the catheter.
Figure 12
Figure 12
The controlled inflation of the balloon using the syringe.
Figure 13
Figure 13
Schematic view of the balloon is carried to the defect area using a grasper outside the endoscope and is placed into the intra-abdominal cavity.
Figure 14
Figure 14
Schematic view of the inflated balloon is retracted, covering the defect area and preventing air leakage.
Figure 15
Figure 15
With the balloon retracted, a barbed suture is applied to the muscularis propria.
Figure 16
Figure 16
Appearance of the inflated balloon covering the defect area.
Figure 17
Figure 17
The muscularis propria is sutured with barbed sutures alongside the inflated balloon.
Figure 18
Figure 18
Appearance of the resection area closed with barbed sutures.
Figure 19
Figure 19
Macroscopic view of the resected material.
Figure 20
Figure 20
Macroscopic view of the resected material.
Figure 21
Figure 21
Histopathologic view of the resected material (H&E, orig. mag. ×2).
Figure 22
Figure 22
Histopathologic view of the resected material (H&E, orig. mag. ×40).
See this image and copyright information in PMC

References

    1. Deprez P.H., Moons L.M.G., OʼToole D., et al. Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2022;54:412–429. - PubMed
    1. Wang K., Gao P., Cai M., et al. Endoscopic full-thickness resection, indication, methods and perspectives. Dig Endosc. 2023;35:195–205. - PubMed
    1. Tada N., Kobara H., Nishiyama N., et al. Current status of endoscopic full-thickness resection for gastric subepithelial tumors: a literature review over two decades. Digestion. 2023;104:415–429. - PubMed
    1. Gu L., Wang X., Ouyang M., et al. Facilitating endoscopic full-thickness resection for gastric submucosal tumors with a novel snare traction method (with video) J Gastroenterol Hepatol. 2024;39:535–543. - PubMed
    1. Lo S.K., Fujii-Lau L.L., Enestvedt B.K., et al. The use of carbon dioxide in gastrointestinal endoscopy. Gastrointest Endosc. 2016;83:857–865. - PubMed

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