Endoscopic Submucosal Dissection (ESD)

ESD is an advanced endoscopic procedure used to remove gastrointestinal tumors that have not entered the deep muscle layer. ESD of appropriately selected lesions may be performed in the esophagus, stomach or colon/rectum.

Under anesthesia, a long narrow tube is passed through the throat to reach the lesion in the Oesophagus / Stomach, or the tube is passed through the anus to reach the lesion in the colon.

The procedure consists of three steps:

1. Injecting fluid into the submucosa to elevate the lesion
2. Cutting the surrounding mucosa of the lesion
3. Dissecting the submucosa beneath the lesion

The aim is to remove the lesion "en bloc" (as one piece)

For upper GI tract ESD you may not eat for 6 hours nor drink for 2 hours prior to the procedure. If ESD is performed in the colon, your physician will prescribe a colon preparation.

You will be asked to change into a gown before the procedure. You will be given a sedative by the anesthesiologist who will be present to monitor your vital signs during the examination. You will not experience any sensation of gagging or choking. A mouthpiece will be placed between your teeth to protect your mouth. You will lie on your left side, and the endoscope will be passed through your mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with your breathing.

After the procedure, you will usually be admitted to the hospital and monitored overnight. The following day Dr Kostalas will discuss whether it is safe for you to be discharged.