Abstract
Underwater endoscopic mucosal resection (EMR) is currently performed in various situations [1] [2] [3] [4]. One advantage to using water is the buoyancy effect on the mucosa, which raises it from the deeper muscularis propria without submucosal injection [1]. However, it takes time to fill the intestinal tract with water, leading to an increased risk of peristalsis and abdominal distension. In addition, underwater EMR on lesions extending into narrow spaces can be difficult to snare because constant water pressure is required. Here, we present a case in which a colonic adenoma extending into the diverticulum was successfully resected using “under-gel EMR” via VISCOCLEAR, a gel product for endoscopic procedures (Otsuka Pharmaceutical Factory, Tokushima, Japan).
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