New progress in endoscopic treatment of esophageal diseases

Figure 1 Process of endoscopic submucosal dissection. A: The lesion is dyed with 2% Lugol's solution; B: Marking of the lesion by argon plasma coagulation probes; C: Submucosal injection; D: The mucosa is incised outside the marker dots, and then the submucosal tissue underneath the lesion is gradually dissected; E: The wound after resection; F: The lesion.

Figure 2 Process of endoscopic submucosal excavation. A: A round-shaped submucosal tumor; B: Removal of the mucosa; C: Dissecting the tumor from the muscular layer; D: The wound after resection; E: Sealing the wound with metallic clips; F: The lesion.

Figure 3 Process of submucosal tunneling endoscopic resection. A: The tumor; B: A submucosal tunnel was created; C: Revealing the submucosal tumor; D: Dissecting the tumor from the muscular layer in the submucosal tunnel; E: The wound after resection; F: Closure of the mucosal incision site with clips.

Figure 4 Process of peroral endoscopic myotomy. A: The esophagogastric junction (EGJ) before surgery; B: Submucosal injection and an initial mucosal incision; C-D: A submucosal tunnel was created; E: The muscle was incised; F-G: The mucosal incision site was closed with clips; H: EGJ after surgery.

Figure 5 Process of thoracoscope-assisted tunnel endoscopic resection. A: Thoracoscopic exploration of the tumor; B: Endoscopic exploration of the tumor; C-D: A submucosal tunnel was created to expose the tumor under endoscopy, which was the same as the submucosal tunneling endoscopic resection procedure; E: The thoracoscopic electric hook was used to separate the esophagus and open the muscular layer over the tumor by blunt dissection, we removed the large tumor from the chest; F: Use of metallic clips to close the mucosal entry; G: Use of thoracoscopy to suture the pleura mediastinalis; H: The lesions.