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Underwater endoscopic mucosal resection for complete R0 removal of an adenoma extending into the appendiceal orifice

Photo by asifakberali from unsplash

Figure 1 (a) Colonoscopy shows a flat elevated lesion adjacent to the appendiceal orifice. It is difficult to identify the border of the lesion. (b) Narrow band imaging (NBI) magnifying… Click to show full abstract

Figure 1 (a) Colonoscopy shows a flat elevated lesion adjacent to the appendiceal orifice. It is difficult to identify the border of the lesion. (b) Narrow band imaging (NBI) magnifying endoscopy shows irregular brown vessels surrounding a tubular white structure, suggesting Japan NBI Expert Team (JNET) classification Type 2A. (c) NBI with underwater immersion provides a clear field of view. NBI enhancement and the magnification effect of water filling shows lesion extension at the appendiceal orifice. (d) After we marked near the appendiceal orifice with a snare tip, water immersion enabled us to capture the entire polyp. Note the direct, clear visualization.

Keywords: resection complete; appendiceal orifice; endoscopic mucosal; mucosal resection; orifice; underwater endoscopic

Journal Title: Digestive Endoscopy
Year Published: 2019

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