Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife

Figure 1 The procedure of endoscopic submucosal dissection using an insulation-tipped diathermic knife (IT-ESD). A: A IIc lesion (black arrows) is seen near the suture line (white arrow) in the remnant stomach; B: Completion of IT-knife cutting around the lesion with a safe lateral margin; C: Abrasion of the submucosal tissue under the circumcised area with IT-knife (white arrow); D: the tumor is completely resected with IT-knife.