Endoscopic submucosal dissection of a large colonic lipoma: Report of two cases

Figure 1 A colonoscopy revealed a soft and yellowish submucosal tumor. A: Colonoscopic view revealed an approximate 5 cm, yellowish, smooth submucosal tumor on the distal descending colon. B: Markings were made around the tumor on the distal side (anal side) with a dual knife and a lifting solution was injected to make a sufficient submucosal cushion from the muscle layer. C: A precut incision was made on the distal side of the tumor. D: Submucosal dissection was performed with a dual knife, and dissection was done from the distal side (anal side) while visualizing the yellowish tumor surface. E: The tumor was completely dissected from the submucosal layer with the proximal side (oral side) of the mucosal layer remaining. F: The tumor was resected completely without complications.

Figure 2 A colonoscopy revealed a yellowish submucosal mass approximately. A: Colonoscopic view showed an approximate 7 cm, yellowish, smooth submucosal tumor on the proximal ascending colon. B: Markings were made around the tumor on the distal side (anal side) with a dual knife; C: A lifting solution was injected to form a sufficient submucosal cushion. D: Precut incision on the distal side and submucosal dissection were performed with the dual knife. E: Dissection was done with dual and hook knives from the distal side (anal side). F: The tumor was resected as en bloc without complications.