Figure 6 TASER platform for the excision of

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Presentation transcript:

Figure 6 TASER platform for the excision of complex rectal polyps and endoscopic images of TASER–ESD Figure 6 | TASER platform for the excision of complex rectal polyps and endoscopic images of TASER–ESD. a | Schematic drawing showing the removal of a rectal polyp using the TASER platform. (b–e) TASER–ESD using the 'Speedboat' RS2 instrument (Creo Medical, UK) and a transanal retractor (Johan Forceps, Karl Storz, Germany). b | A 6 cm granular type LST at the mid rectum. c | The 'Speedboat' device resects the submucosal layer (bipolar radiofrequency cutting modality) while a transanal retractor withdraws the polyp to expose the submucosal plane. d | Final result of en bloc excision. e | Scar inspection with the use of chromoendoscopy, showing no recurrence at the first follow-up. (f–i) TASER–ESD using a ball-tipped FlushKnife (Fujifilm, Japan) and transanal full-thickness excision. f | A 5 cm rectal polyp with severe submucosal tethering. g | isolation of the lesion with FlushKnife mucosal incision. h | Transanal full-thickness excision is performed for the most fibrotic part of the polyp base utilizing surgical scissors. i | Closure of the full thickness defect with surgical sutures. EMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection; LST, laterally-spreading tumour; TASER, transanal submucosal endoscopic resection. Saunders, B. P. & Tsiamoulos, Z. P. (2016) Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2016.96