ASGE DDW Videos from Around the World | 2026-SELECTIVE SEPARATION OF RECTAL WALL USING SEQUENTIAL NTRAMUSCULAR AND FULL THICKNESS DISSECTION OF RECURRENT T2 RECTAL ADENOCARCINOMA AFTER CHEMORADIOTHERAPY WITH BIPOLAR/MICROWAVE ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE

SELECTIVE SEPARATION OF RECTAL WALL USING SEQUENTIAL NTRAMUSCULAR AND FULL THICKNESS DISSECTION OF RECURRENT T2 RECTAL ADENOCARCINOMA AFTER CHEMORADIOTHERAPY WITH BIPOLAR/MICROWAVE ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE

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Video Transcription

Video Summary

A 66-year-old man with recurrent T2N0M0 rectal adenocarcinoma after chemoradiotherapy underwent bipolar microwave-assisted endoscopic subcausal dissection using a novel device. The procedure enabled selective dissection through intramuscular, intermuscular, and full-thickness rectal wall layers while preserving the anal sphincter and puborectalis-associated anatomy. A mesorectal arteriole bleed was controlled efficiently with microwave coagulation. Histology confirmed circular muscle infiltration with preserved longitudinal muscle. Follow-up endocytoscopy showed scar and granulation tissue with small new glandular islands. The technique offered precise cutting, effective hemostasis, and may be a sphincter-preserving option for selected T2 rectal cancers.

Asset Subtitle

Z.P. Tsiamoulos, T. Alexopoulos, D. Polymeros, H. Kaltsidis, A. Oikonomakis, J. Sebastian, S. Zeidan

Keywords

rectal adenocarcinoma

microwave-assisted endoscopic dissection

sphincter-preserving surgery

hemostasis

T2 rectal cancer