Endoscopic Submucosal Single- or Multi-tunnel Dissection for Near-Circumferential and Circumferential Superficial Esophageal Neoplastic Lesions

Figure 1

Endoscopic submucosal single-tunnel dissection (ESSTD) or endoscopic submucosal multitunnel dissection (ESMTD) for near-circumferential esophageal lesions. (a) Iodine staining of the lesions. (b) Endoscopic ultrasound (EUS) imaging. (c, d) Magnifying endoscopy with narrow-band imaging (ME-NBI). (e) Marking the margin of the lesion with a Dual-Knife. (f) Posterior tunnel entrance creation by submucosal dissection with an IT knife. (g) Anterior incision after submucosal injection with a Dual-Knife. (h) Operation in three tunnels. (i) The resected posterior lesion specimen cut and flattened on a foam board after the operation. (j) The artificial wound after endoscopic submucosal tunnel dissection (ESTD). (k) Esophageal stricture. (l) Endoscopic water balloon dilation.

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