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ENDOSCOPIC SUBMUCOSAL DISSECTIO

Endoscopic Submucosal Dissection

Endoscopic submucosal dissection (ESD) is a procedure to remove deep tumors from the gastrointestinal (GI) tract. It may be performed as a day-care procedure or an indoor procedure requiring 24 hours hospitalization.

Only a few centers in the India perform ESD because the procedure requires a high degree of expertise and this is the only center in Saurashtra-Kutch region with expertise to perform it. ESD helps patients recover faster, often with less pain, than with open or laparoscopic surgical procedures with outcomes comparable to that of surgical procedures. .

Our area of clinical expertise include:

Indications:

❖ Barrett’s Esophagus
❖ Early-stage cancerous tumors or colon polyps
❖ A Colonoscopy allows for viewing of the lining of the large bowel with a flexible tube. You are required to take medication the day prior to your procedure to cleanse your bowel. You will be given sedation during the procedure.
❖ Tumors of the esophagus, stomach or colon that have not yet entered the deeper layer of the GI wall, with minimal or no risk of cancer spreading
Staging of cancer (determining the cancer level) to develop treatment plans

Pre-procedure preparation:
❖ Do not take anything orally from the midnight ❖ For procedures involving large intestine, patient is required to drink bowel cleansing medicine on the day of the procedure ❖ Do not take anti-diabetes medicines on the day of the procedure ❖ Certain blood thinning agents also need to be stopped a few days prior to the procedure as per doctor’s advise
Procedure:
❖ The procedure is done under sedation ❖ Endoscope is inserted and the tumour margins are marked ❖ Saline solution is injected underneath the area to be cut to raise it. ❖ Tissue is cut along the marked margins with specialised knife ❖ Cancerous tissue is removed and is sent to the laboratory for examination ❖ Bleeding is stopped.and small perforation, if any, is sealed.
Complications & Drawbacks:
❖ Sore throat, nausea or vomiting, abdominal cramps ❖ Bleeding, Perforation, Remnant Tumour, Recurrence

DEPT OF MEDICAL GASTROENTEROLOGY

DR. K. K. RAWAL (MD, DM – GASTRO)
DR. AVVAL  K. SADIKOT (MD, DNB-GASTRO)
DR. CHINTAN H. KANSAGRA (MD,DNB – GASTRO)
DR. CHINTAN M. MORI (MD,DNB – GASTRO)

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