Endoscopic Submucosal Dissection (ESD)
The most advanced endoscopic resection technique - enabling en-bloc removal of any size lesion with precise margin control, avoiding surgery for large adenomas and selected early cancers. Available at selected specialist centres.
What is Endoscopic Submucosal Dissection (ESD)?
Endoscopic Submucosal Dissection (ESD) is the most technically advanced endoscopic resection technique, allowing en-bloc removal of large or complex mucosal lesions of any size. After submucosal injection, specialised endoscopic knives carefully dissect the submucosal layer under direct vision - freeing the lesion from the underlying muscle and removing it as a single intact specimen. Dr. Samhitha Reddy offers ESD at Lux Hospitals, Hyderabad at selected specialist centres with the appropriate equipment and expertise - for large flat adenomas, early colorectal cancers, and complex lesions where EMR cannot achieve en-bloc resection. As part of the best polypectomy surgeons in Hyderabad programme, ESD's en-bloc specimen allows definitive assessment of lateral and deep margins.
How the Procedure Works
Pre-procedure Assessment
MRI, endoscopic ultrasound, or chromoendoscopy assesses depth of invasion to confirm suitability for endoscopic vs surgical resection.
Extensive Submucosal Injection
Viscous submucosal solution is injected extensively beneath the lesion to create a thick cushion for dissection - larger volumes than used for EMR.
Circumferential Incision
An IT knife or Dual knife marks and incises the mucosa circumferentially 5 mm outside the lesion margins - defining the dissection boundary.
Submucosal Dissection
The endoscopic knife carefully dissects the submucosal layer under direct vision - advancing systematically beneath the lesion while maintaining the cushion.
En-bloc Retrieval & Orientation
The lesion is retrieved intact and pinned on a board for pathological orientation. Margin status, depth of invasion, and lymphovascular invasion are assessed precisely.
Outcomes
Who Needs This Treatment?
- →En-bloc resection of any size lesion - definitive margin assessment in a single specimen
- →Avoids major bowel surgery for large adenomas and selected early cancers
- →Superior recurrence rates compared to piecemeal EMR for large lesions
- →Curative for T1a early colorectal cancers with no lymphovascular invasion
- →Minimally invasive - no abdominal incisions or bowel resection
- →Available at selected specialist centres including Lux Hospitals, Hyderabad
ESD represents the pinnacle of endoscopic surgical technique. The ability to remove a lesion of any size en-bloc - obtaining a perfect specimen for pathological assessment - with no external incision is a genuinely transformative capability for patients who would otherwise face major bowel surgery.
— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon
Common Questions
Frequently Asked
Not sure which treatment is right for you?
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