Removal of gastrointestinal tumors without surgery using a new method - ESD

A technique that originated in Japan in the early 2000s for the endoscopic removal of early-stage stomach tumors. In the past decade, the method has also spread to Western countries and has recently become available in Israel.

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The majority of malignant tumors in the gastrointestinal tract begin as precancerous lesions that develop in the most superficial layer of the gastrointestinal wall - the mucosa. As the tumor grows, it begins to invade deeper layers of the bowel wall, and from there it may spread to nearby lymph nodes and send metastases to more distant areas of the body.

The accepted treatment for these precancerous lesions is resection through an endoscopic procedure.

The advantages of this method over other resection techniques such as EMR include the ability to remove lesions of any size in a single piece, which allows for thorough pathological examination of the specimen and accurate assessment of the risk of lymph node metastasis according to the depth of tumor invasion into the submucosa.

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All procedures involved in this method are performed under anesthesia or sedation, through an endoscope inserted via the mouth or rectum, without surgical incision.

Initially, the tumor boundaries are marked through the endoscope, and then fluid is injected beneath the tumor directly into the submucosal layer, to allow separation of the tumor from the deeper layers of the wall. After making a circumferential incision around the tumor area, Dr. Sergei Vosko will cut the submucosa with a special knife that separates the tumor from the surrounding tissues. Once the tumor has been completely removed, it will be sent for pathological laboratory examination.

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Dr. Sergei Vosko, head of the Endoscopy Unit at Hadassah Medical Center and founder of the Department of Advanced Endoscopic Resection at Shamir Medical Center (Assaf Harofeh Hospital), performs examinations, treatments, and procedures using Advanced Endoscopy and artificial intelligence.

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