LAUSR

Figure 2. Narrow-band imaging magnification showed type 2A per the Japan Narrow Band Imaging Expert Team classification. Colonic diverticula lack a muscular layer because they typically develop as a result of the herniation of mucosa and submucosa through a muscle layer that the vasa recta penetrates. The herniation is caused by increased intraluminal pressure. Endoscopic resection of tumors near colonic diverticula is difficult and dangerous because of the aforementioned anatomic features. Endoscopic resection–related adverse events have been reported. In recent years, cold snare polypectomy (CSP) has been widely performed for small colorectal tumors. CSP causes less delayed bleeding and has shorter procedure times compared with hot snare polypectomy. Although CSP has been effective in reducing the risk of perforation for colorectal tumors adjacent to a diverticulum, the removal strategy for small colorectal tumors involving a diverticulum remains unclear. We report the successful resection of a colonic tumor partially extending into a colonic diverticulum using an S-O clip for traction (Video 1, available online at www.VideoGIE.org). A flat, elevated lesion with a diameter of 8 mm was observed in the ascending colon. The lesion partially