Endoscopic submucosal dissection is a minimally invasive procedure to remove irregular tissue from your digestive tract. Compared to open surgery, it offers a quicker, less painful recovery. You may need endoscopic submucosal dissection if you have tumors or precancerous lesions beneath your mucosa, the membrane lining your gastrointestinal tract.
Endoscopic submucosal dissection is a minimally invasive procedure to remove irregular tissue from your gastrointestinal (GI) tract. During the procedure, a gastroenterologist (doctor specializing in gastrointestinal diseases) uses a long, flexible tube with a camera called an endoscope. They insert the endoscope through your mouth or anus (butthole), depending on which part of your digestive tract they’re treating. Then they insert surgical tools through the endoscope to remove irregular tissue.
Endoscopic techniques allow your doctor to reach your GI tract without making any incisions. This approach means you recover faster and with less pain than after open surgery.
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You usually have endoscopic submucosal dissection to remove precancerous or cancerous growths (lesions, polyps or tumors) in your digestive tract. Endoscopic submucosal dissection is typically used to treat:
Endoscopic mucosal resection and endoscopic submucosal dissection are both minimally invasive procedures to treat your GI tract. But each targets a different part of your digestive tract.
You’ll receive specific instructions to prepare for endoscopic submucosal dissection. If your gastroenterologist is treating your upper GI tract (esophagus, stomach or small intestine), you’ll need to avoid eating or drinking for several hours before the procedure. If they’re treating your lower GI tract (large intestine, which includes your rectum and colon), you may need to perform a bowel prep.
Bowel prep involves taking laxatives to empty your colon. This allows your gastroenterologist to clearly see inside your colon and rectum.
You may receive general anesthesia to put you to sleep for the procedure, or for monitored anesthesia care, where your anesthesiologist keeps you comfortable and relaxed.
During endoscopic submucosal dissection, your gastroenterologist:
Endoscopic submucosal dissection usually takes around one to three hours.
Your gastroenterologist sends a sample of the irregular tissue to a laboratory. A pathologist (doctor who specializes in studying body tissue) analyzes the tissue sample for signs of disease.
You move to a recovery room while the anesthesia wears off. You may return home the same day or stay in the hospital overnight. You’ll need someone to drive you home, as it can take up to 24 hours for the full effects of anesthesia to go away completely.
Depending on the area treated, you may have some mild to moderate side effects for a day or two, including:
Having a small amount of blood in your stool isn’t uncommon, but it should stop within 24 hours. Call your gastroenterologist immediately if you have rectal bleeding or blood in your stool for longer than 24 hours after this procedure.
Endoscopic submucosal dissection allows your gastroenterologist to remove GI tumors without making large incisions or removing part of your digestive tract. Compared to open surgery, endoscopic techniques offer multiple benefits, like:
Complications of endoscopic submucosal dissection are rare but may include:
Most people return to work about five days after endoscopic submucosal dissection. You may need to wait longer if you have an active job. You may have irregular bowel movements for about a week after the procedure.
Endoscopic submucosal dissection is a highly successful procedure. Some studies have shown that tumors grow back in only 1% of people who undergo the procedure.
You’ll likely have a follow-up appointment with your gastroenterologist about two weeks after endoscopic submucosal dissection. Your gastroenterologist will discuss your results and whether you need further treatment.
Call your gastroenterologist immediately if you notice any signs of complications after endoscopic submucosal dissection, including:
Endoscopic submucosal dissection is a minimally invasive procedure. It doesn’t involve large incisions like you’d receive in a major open surgery.
A note from Cleveland Clinic
Endoscopic submucosal dissection is a minimally invasive procedure to remove irregular growths or tumors from the superficial layers of your digestive tract. It allows your gastroenterologist to remove tumors without making any incisions. Compared to open procedures, endoscopic procedures allow you to recover more quickly with less pain and a lower risk of complications.
Last reviewed by a Cleveland Clinic medical professional on 09/19/2023.
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