Expanding endoscopic boundaries: Endoscopic resection of large appendiceal orifice polyps with endoscopic mucosal resection and endoscopic submucosal dissection

Figure 1 Step-by-step demonstration of a polyp removal via endoscopic submucosal dissection. A: A 30 mm polyp occupying 50% of the appendiceal orifice circumference is visualized; B: The polyp borders are marked using the tip of the dual knife. Adequate lifting of the submucosa is achieved after the injection of Hespan Solution; C: The resection bed is seen after the dissection of the polyp from the underlying deeper layers; D: The defect is completely closed with 4 hemostatic clips; E: The result is an en bloc resection of the polyp.