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EDUARDO ALBENIZ ARBIZU: Here we have a 71-year-old male referred with a flat lesion on the right colon. The previous colonoscopy was difficult, and the access to the polyp was unstable. We start in the colon with DiLumen.
The case was referred for ESD. But when we saw the lesion, we decided to perform an underwater EMR. So we had the perfect weapon, the DiLumen platform.
Now, we are sorting in the colon. You can see that we are working near the cecum. In this part of the video, we are deploying the fore balloons. And we have deployed also the after balloon to have a good stabilization.
Between the two balloons, we introduce water. So it's very easy to create a water space. Now, we can see the polyp, but we decided to perform an underwater EMR instead of ESD because it was a not very big lesion.
Now, we can see that we can flatten also the lesion. It is narrowed very easily. We tried to cut the lesion with the snare, all the lesion in one piece. This is how our first and main intention.
But when we are cutting, we saw remaining tissue in one third, but nothing happens. This is our first cut. But we had remaining tissue in one third of the polyp. So we needed another second cut.
We fill again with cleaner water. We can see the polyp very easily. We reopen the snare. And always, we try to cut the lesion and good margins.
And the lesion was removed with two cuts. Now, we introduce water. So we see very clear some submucosal space. No remaining tissue at all. So we don't need chromoendoscopy for this.
After that, we remove the lesion through the DiLumen platform. So this is an important function of the DiLumen is the conduit function. So we can remove the endoscope all the time that we need.
We remove the fore balloon and we maintain the after balloon. Now, we see some vessels, and we use the tip of the snare to make substitute as an air coagulation.
But thinking about the person, after we decided to clip the lesion-- because it was a patient with comorbidities, we are working in the right colon and the lesion was over 2 centimeters. So we decided to clip the lesion with three clips [INAUDIBLE]. So here, we can see a case where DiLumen was very effective. Thank you for your attention.
