Advanced technique to remove larger or deeper GI lesions en bloc by cutting through the submucosal layer.
Why it’s done
• Early cancers >2 cm or with fibrosis
• High-grade dysplasia in Barrett’s esophagus or stomach
Preparation
• Fasting or bowel prep per location
• Stop anticoagulants per protocol
• Discuss higher-risk of complications
Procedure
• Deep sedation or anesthesia
• Mark lesion margins, submucosal injection, then dissection with specialized knives
• Duration: 1–3 hours
Afterwards
• Hospital stay 1–2 days
• Liquid diet for 1–2 days; advance cautiously
Risks
• Bleeding (5–10%)
• Perforation (3–5%)
• Stricture formation (5–10%)
