Underwater endoscopic resection: an alternative for difficult colorectal polyps
Dalton Marques Chaves, PhD,
Hélcio Pedrosa Brito, MD,
Lumi Tomishige Chaves,
Adriana Vaz Safatle-Ribeiro, PhD,
Gilberto Fava, PhD,
Eduardo Guimarães Hourneaux de Moura, PhD,
Beatriz Mônica Sugai, PhD
Affiliations
Dalton Marques Chaves, PhD
Fleury Medicine and Health, São Paulo, Brazil; Clinics Hospital of São Paulo University, São Paulo, Brazil; Reprint requests: Dalton Marques Chaves, PhD, Fleury Medicine and Health, Clinics Hospital of São Paulo University, Rua Montezuma, 183, São Paulo, Brazil 05436-080.
Hélcio Pedrosa Brito, MD
Fleury Medicine and Health, São Paulo, Brazil
Lumi Tomishige Chaves
Medical School of the Federal University of São Paulo, São Paulo, Brazil
Adriana Vaz Safatle-Ribeiro, PhD
Clinics Hospital of São Paulo University, São Paulo, Brazil
Gilberto Fava, PhD
Cancer Hospital of Barretos, Barretos, Brazil
Eduardo Guimarães Hourneaux de Moura, PhD
Clinics Hospital of São Paulo University, São Paulo, Brazil
Background and Aims: Underwater endoscopic resection can be an alternative to standard resection techniques to remove difficult colorectal polyps. This video shows 4 cases of underwater resection of large colorectal polyps. Methods: Underwater resection consists of complete filling of the lumen through the accessory channel, using an infusion pump followed by snare resection of the polyp. We present 4 cases: a 3-cm pseudodepressed laterally spreading tumor (LST) in the sigmoid colon, a 6-cm pedunculated polyp with a thick stalk in the sigmoid, a 7-cm sessile lesion in the midrectum, and a 4-cm LST in the distal rectum close to the dentate line, resected with a monofilament snare or a multifilament snare. Results: All tumors were successfully resected without any adverse events or residual lesions during follow-up. Conclusions: The underwater technique is a good alternative to standard resection techniques to remove difficult colorectal lesions.
