Endoscopic Submucosal Dissection (ESD)
– Procedure for Cancer Prevention
ESD is a highly advanced and technically difficult Endoscopic technique that evolved in Japan to remove superficial cancers of the colon, esophagus, and stomach. It is used for both small and large precancerous and early cancers arising in the mucosa (superficial lining of the GI tract).
It gives us the ability to remove the entire lesion in one piece, so that it can be studied under a microscope to confirm that the cancer is entirely removed. This in turn prevents the patient having to undergo abdominal or chest surgery with all its associated complications, time to recover, and costs.
ESD is a procedure that is minimally invasive and organ sparing.
Gastric ESD(top) and Rectal ESD(bottom)
Who does it benefit:
Patient who have large benign colon polyps who have been recommended general surgery by their GI or PCP.
Patient who have polyps/tumors in their GI tract that may be malignant or are suspicious and hence need to be removed. This technique is a minimally invasive technique that is an alternative to abdominal surgery and can be performed as an out-patient procedure.
It can be used to remove superficial cancers of the esophagus, stomach, colon, and rectum.
Who does ESD not benefit:
Patient who have advanced cancers that are invading deeper into the wall of the GI tract or have spread to surrounding lymph nodes or other organs. These patients will require extensive surgery and exploration.
Appointment - Contact us at (850) 877-2105 or via the contact form to make an appointment to discuss your specific situation.
Live recording of ESD procedure
Dr. Hardeep Singh, MD
ESD Closure and 3 month follow-up
esD
FAQs
Q. When is ESD indicated?
A. Its indicated for precancerous and early cancerous polyps or growths which were in the past removed surgically with an abdominal incision and a prolonged hospital stay and recovery.
Q. What lesions qualify for this procedure?
A. Polyps in the stomach, Duodenum(small bowel) and Colon both large and small, especially those appearing malignant. Lesions that your doctor may say requires general surgery.
Q.When is the ESD procedure not indicated for growths/ polyps.
A. When the growth is proven malignant and is large and invading the deeper layers of the GI tract, i.e locally advanced.
Q. How do I know that the that my lesion can be resected(cut out) endoscopically(non-surgically) by ESD?
A.The physician may perform a test called EUS (Endoscopic Ultrasound) to determine the depth of the lesion to confirm that it can be removed endoscopically as an alternative to a surgical procedure.
Q.Who performs this procedure and does my physician do it?
A.There are a handful of trained Gastroenterologist in the South East that perform this advanced procedure. It requires additional training, is technically difficult and very time consuming.
Q. What is the major advantage of this procedure?
A. ESD can be performed endoscopically and the patient can be discharged home the same day and be at work the next day.
Q. What are the disadvantages of ESD?
A. Very few Gastroenterologist perform this highly technical procedure. If the resection does not have clear(negative) margins, the patient may still have to go to abdominal surgery.
Some cancers can go deeper than imaging shows leading to positive resection margins.
Q. When should I consider having this procedure rather than going for general abdominal surgery.
A. For lesions that are suspicious for cancer or have early cancer this procedure can be curative and avoid General abdominal surgery with all its risks and complications.