Do you have what it takes for challenging endoscopic submucosal dissection cases?

Figure 1 Lesion at the cardia, just below the gastroesophageal junction. A: Retroflexed view of the cardia; B: A circumferential incision was made from the oral to the anal side, which is then vulnerable to bleeding; C: Submucosal dissection from the anal to the oral side; D: The lesion was completely resected.

Figure 2 Lesion at the fundus. A: The lesion was located between the fundus and the anterior side of the high body; B: Submucosal dissection was performed from the cardia to the fundus.

Figure 3 Lesion at the pyloric channel extending to the duodenal bulb. A: Nodular elevated lesion involving the pyloric channel; B: Polypoid mass lesion at the duodenal bulb, retroflexed view; C: Incision and submucosal dissection were performed from the duodenal bulb to the antrum; D: The 180° circumferential dissection was completed; E: The en bloc resection was completed.

Figure 4 Lesion at the duodenum. A: Two flat elevated lesions at the duodenal bulb; B: Circumferential incision; C: Submucosal dissection (the lifting of the lesion after submucosal injection was limited); D: The en bloc resection was completed.