ASGE-JGES Endoscopic Submucosal Dissection ESD (On-demand) | October 2025-Indications and Preprocedural Evealuation for Lower ESD

Indications and Preprocedural Evealuation for Lower ESD - Sano

Video Transcription

Video Summary

The speaker discusses the development and evolution of nanoband imaging (NBI) and its role in colonoscopy over 26 years. Beginning with the fundamental structures of normal colon crypts and glands, they explain microvascular patterns visible with advanced endoscopy techniques. The speaker introduced the micro-excavation classification in 2006, classifying lesions into four types to guide treatment strategies including polypectomy, EMR, and ESD. Collaborations with international experts led to the NICE classification in 2011, a simplified system distinguishing non-neoplastic, neoplastic, and invasive cancer types, though it has limitations. The JNET classification, widely used in Asia and increasingly in Europe, categorizes lesions into four types to improve diagnosis accuracy and guide interventions. Emphasis was placed on endoscopic diagnosis over size for treatment decisions, including novel procedures such as intermuscular dissection and partial muscular resection for specific cases. The speaker encourages use of freely available diagnostic posters to aid clinical practice.

Keywords

Nanoband Imaging

Colonoscopy

Micro-excavation Classification

NICE Classification

JNET Classification

Endoscopic Diagnosis