Gel-assisted esd for removal of a rectal non granular laterally spreading tumor pseudo-depressed type with suspicion of superficial submucosal invasive cancer

A new gel lifting solution was used for the removal of a rectal non granular LST pseudo-depressed type, with suspicious pit pattern by ESD in a 64 y/o male. Briefly, 12ml of ORISETM gel (Boston Scientific) was injected with strong submucosal lifting, no per-procedural bleeding, no needed added per-procedural injection. An easy dissection of 15 min let us remove en-bloc a 30x25mm specimen revealing clear margins of a well-differentiated adenocarcinoma, without lymphovascular invasion or budding but submucosal invasion of 1038µm, giving a 1-2% risk of lymph node metastasis.