Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2932
Peer-review started: August 28, 2023
First decision: November 1, 2023
Revised: November 8, 2023
Accepted: December 8, 2023
Article in press: December 8, 2023
Published online: December 27, 2023
Processing time: 121 Days and 1.7 Hours
Endoscopic submucosal dissection (ESD) can be used for the en-bloc removal of superficial rectal lesions; however, the lack of a traction system makes the procedure long and difficult in the presence of extensive lesions.
A large polyp occupying 2/3 of the rectal circumference and extending 5 cm in length was removed by ESD with the help of laparoscopic forceps introduced via trans-anal rectoscopic assisted minimally invasive surgery, a disposable platform designed to aid in transanal minimally invasive surgery. Traction of the polyp by forceps during the operation was dynamic, and applied at various points and in various directions. The polyp was removed en-bloc without complications in 1 h and 55 min. A sigmoidoscopy performed 50 d later showed normal healing without polyp recurrence.
The technique presented here could overcome the issues caused by lack of traction during ESD for rectal lesions.
Core Tip: Endoscopic submucosal dissection (ESD) can be used for the en-bloc removal of superficial rectal lesions; however, the lack of a traction system makes the procedure long and difficult in the presence of extensive lesions. In this case, the use of trans-anal rectoscopic assisted minimally invasive surgery could overcome the problem of traction during ESD for rectal lesions.