ASGE DDW Videos from Around the World | 2026-FULL THICKNESS ENDOSCOPIC RESECTION OF RECURRENT ANASTOMOTIC RECTAL ADENOCARCINOMA WITH BIPOLAR-MICROWAVE ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE COMBINED WITH A NEW TRANS-ANAL PLATFORM

FULL THICKNESS ENDOSCOPIC RESECTION OF RECURRENT ANASTOMOTIC RECTAL ADENOCARCINOMA WITH BIPOLAR-MICROWAVE ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE COMBINED WITH A NEW TRANS-ANAL PLATFORM

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Video Transcription

Video Summary

A recurrent rectal adenocarcinoma at an anastomotic site was successfully removed using a novel bipolar microwave-assisted endoscopic semicosal dissection with a trans-anal CO2 platform. The lesion recurred 18 months after chemoradiotherapy and was located between surgical clips with disrupted rectal wall layers. The device helped maintain stable distension, reduce oozing, and safely dissect through intramuscular and deep muscular planes into neo-mesorectal fat. The 25-minute procedure had no complications. Six-month surveillance showed only scar tissue and chronic inflammation, with no residual tumor on endocytoscopy or biopsy.

Asset Subtitle

Submitted by Theodoros Alexopoulos

Keywords

rectal adenocarcinoma

endoscopic dissection

trans-anal CO2 platform

anastomotic recurrence

microwave-assisted surgery