Endoloop ligation after endoscopic mucosal resection using a transparent cap: A novel method to treat small rectal carcinoid tumors

Figure 1 Utilizing endoloop ligation after cap-endoscopic mucosal resection using a transparent cap to remove rectal carcinoid tumor. Pathology suggested positive margins and further transanal endoscopic microsurgery pathology was negative. A: Endoscopy showing a rectal carcinoid about 10 mm in diameter; B: An electric snare mounted on the transparent cap on the inner lens end; C: Wound after resection; D: Nylon endoloop device installed on the inner lens end; E: Wound after nylon endoloop ligation resection; F: Endoscopic resection of the intact tumor; G: Pathological specimen suggesting a carcinoid, vertical margin positive (× 10); H: Positive immunohistochemical staining for CD56 (× 100); I: Positive immunohistochemical staining for chromogrin (× 100); J: Positive immunohistochemical staining for Syn (× 100); K: Immunohistochemical staining for Ki-67 (< 2%; × 100); L: Transanal endoscopic microsurgery surgery did not identify tumor cells (× 10).