Endoscopic Submucosal Dissection

What is ESD?

Endoscopic submucosal dissection (ESD) is a procedure that is used as an alternative to surgical resection for the removal of tumors of the GI tract. It is a novel procedure that was developed in Japan in the early 2000s. The ESD technique can remove large areas of precancerous or cancerous cells from the lining of the esophagus, stomach, or colon in a single piece. The procedure entails injecting colored fluid into the areas of damage and then carefully, slowly dissecting and removing the tissue that is diseased.

What Has Made ESD So Popular?

Over the last few years, advances have been made that make ESD safer and easier to perform. Some of those advances are listed below:

  • Development of many electrosurgical knives for various procedural steps
  • Advanced imaging or chromoendoscopy to better locate the edge of a lesion and its borders
  • Better solutions for submucosal injections
  • New suturing techniques and devices to close perforations or defects.

These advancements have allowed ESD to be a safe, quick, and commonly outpatient procedure.

What Conditions Can Be Treated by ESD?

ESD can be used to treat premalignant or malignant conditions that affect the inner lining of the GI tract – particularly in the esophagus, stomach, and colon.  Some conditions that can be addressed include the esophageal, stomach, and rectal cancer, along with large premalignant polyps in these organs.

What Should I Expect During This Procedure?

If you are having an ESD, you will receive instructions from your doctor about how to prepare for the appointment. All patients undergoing ESD will receive anesthesia for the procedure so as not to feel any pain or remember the procedure. During the procedure, the doctor will pass an endoscope (a flexible tube with camera and lights) into the mouth or rectum (depending on the location of the tumor). The areas of importance will be injected with fluid to raise it from the healthy tissue. Then an endoscopic knife will be used to remove the unhealthy tissue. Most ESD procedures are outpatient procedures, meaning the patient will go home the same day.

What Complications Are Possible?

Understand that all procedures, whether surgical or endoscopy include inherent risks. However, ESD is both effective overall and safe for patients.  Adverse events reported with this technique include bleeding or perforation.  However, the overall risks of these complications is low.


Is endoscopic submucosal dissection safe?

Endoscopic submucosal dissection (ESD) is a safe and effective treatment for various gastrointestinal disorders. The procedure is minimally invasive and has a low risk of complications. ESD can be performed on an outpatient basis, and patients can typically return to their normal activities within a few days.

How long does it take to recover from an endoscopic mucosal resection?

Endoscopic mucosal resection (EMR) recovery usually takes a few days. You may have discomfort during this time, but your doctor can prescribe medication to help with this. You may also need to take it easy for a few days and avoid strenuous activity. You’ll likely be able to eat and normally drink soon after the procedure.

How long is endoscopic submucosal dissection?

ESD is generally a safe and effective procedure with a low risk of complications. The process typically takes 30-60 minutes to complete, depending on the size and location of the abnormal tissue.

Who may need endoscopic submucosal dissection?

If you have been diagnosed with a precancerous condition or early-stage cancer in your gastrointestinal tract, your doctor may recommend endoscopic submucosal dissection (ESD).

ESD may be an option for you if you have:

A precancerous condition, such as Barrett’s esophagus
Early-stage cancer, such as a gastric cancer
A large polyp that cannot be removed with a conventional endoscopy

What is colonoscopy with endoscopic mucosal resection?

A colonoscopy with endoscopic mucosal resection (EMR) is a minimally-invasive procedure used to treat abnormal growths in the colon, also known as colorectal polyps. EMR involves removing the abnormal tissue through a special endoscope, a long, flexible tube equipped with a tiny camera and light. This process is usually performed on an outpatient basis, and most people can return to normal activities the same day

Endoscopic Submucosal Dissection ESD in Dallas, Tx

Are you interested in learning more about ESD or other treatment options? We invite you to contact us to learn more. Dr. Prashant Kedia is a therapeutic endoscopist and gastroenterologist serving patients in the Dallas-Fort Worth area and beyond. Call today to schedule an appointment at (214) 941-6891.

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