Gastric endoscopic submucosal dissection in Western countries: Indications, applications, efficacy and training perspective

Figure 1  The “virtuous circle”: In a single step, it is possible to obtain R0-resection, characterization, diagnosis and histological staging of the lesion.

Figure 2 Multitasking device for multiple procedure steps. A: Marking; B: Mucosal incision; C: Submucosal infiltration; D: Submucosal dissection.

Figure 3 Hemostatic maneuver. A: Submucosal visible vessel; B-E: Coagulation of the vessels with the endoscopic submucosal dissection knife or with forceps.

Figure 4  Whole resected specimen pinned down on a polystyrene block.