Endoscopic submucosal dissection technique

Panel A shows careful endoscopic assessment of the focally ulcerated neoplastic lesion located in the mid gastric antrum. Narrow band imaging was also used but is not shown.
Panel B shows circumferential cautery marking at 5 mm from the margin of the lesion.
Panel C shows submucosal incision around the lifted lesion following the submucosal injection with methylene blue containing solution.
Panel D shows successful en bloc dissection of the lesion. Pathologic specimen revealed intramucosal cancer with no involvement of the lateral and vertical margins.