ASGE DDW Videos from Around the World | 2025-UNDERWATER EN BLOC R0 INTERMUSCULAR DISSECTION OF A T1B RECTAL ADENOCARCINOMA IN A PATIENT WITH DECOMPENSATED CIRRHOSIS WITH PROPHYLACTIC USE OF RECOMBINANT FACTOR VII

UNDERWATER EN BLOC R0 INTERMUSCULAR DISSECTION OF A T1B RECTAL ADENOCARCINOMA IN A PATIENT WITH DECOMPENSATED CIRRHOSIS WITH PROPHYLACTIC USE OF RECOMBINANT FACTOR VII

Back to course

Video Transcription

Video Summary

The transcript describes a case of intermuscular dissection to treat a 60-year-old patient with T1b rectal adenocarcinoma and decompensated cirrhosis using recombinant factor VII due to bleeding risks. Traditional endoscopic submucosal dissection (ESD) was adapted for this complex case, utilizing an underwater approach for improved visualization and vessel management. This method allows for R0 resection without affecting the possibility of future surgery. Recombinant factor VII was used prophylactically, marking a novel approach for this scenario. Results indicate a high success rate with no major complications, supporting this technique as an alternative to more invasive procedures.

Asset Subtitle

Derek Gindi

Keywords

intermuscular dissection

rectal adenocarcinoma

recombinant factor VII

underwater approach

R0 resection