Underwater endoscopic submucosal dissection for large colonic lipomas: a case series.
- 1Gastrointestinal Center, Sano Hospital, Kobe, Japan.
- 2Department of Endoscopy, NEO Healthcare Clinic, Osaka, Japan.
Abstract
Background and aims
Colonic lipomas are benign tumors arising from mature adipose tissue and are usually asymptomatic; however, they can occasionally lead to adverse events, such as intussusception, abdominal pain, and GI bleeding. Colonic lipomas can be removed using a variety of endoscopic techniques, including endoscopic unroofing, loop-assisted resection, EMR, and endoscopic submucosal dissection (ESD). However, symptomatic lipomas are often large, and the visualization of the lipoma base during resection is difficult, rendering treatment challenging. Here, we report a case series of patients with large colonic lipomas who underwent underwater ESD (U-ESD).Methods
Between April 2024 and March 2025, 4 patients with symptomatic or large colonic lipomas (≥30 mm), which were identified during colonoscopy, underwent U-ESD at our center.Results
The buoyancy-based underwater technique provided continuous countertraction enhanced the visualization of the lesion base, and improved exposure of the dissection plane. In all 4 cases, lesions were safely and efficiently resected by U-ESD.Conclusions
U-ESD may be considered a useful approach for the endoscopic resection of large colonic lipomas.
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BibTeX
@article{nakajima2026underwater,
title = {{Underwater endoscopic submucosal dissection for large colonic lipomas: a case series.}},
author = {Riku Nakajima and Wataru Sano and Sachiko Shimizu and Naoki Sugimura and Daizen Hirata and Mineo Iwatate and Mikio Fujita and Yasushi Sano},
journal = {VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy},
year = {2026},
month = may,
doi = {10.1016/j.vgie.2026.05.001},
url = {https://europepmc.org/article/MED/42923290},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Underwater endoscopic submucosal dissection for large colonic lipomas: a case series.
AU - Riku Nakajima
AU - Wataru Sano
AU - Sachiko Shimizu
AU - Naoki Sugimura
AU - Daizen Hirata
AU - Mineo Iwatate
AU - Mikio Fujita
AU - Yasushi Sano
PY - 2026
DA - 2026/05/20
JO - VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy
DO - 10.1016/j.vgie.2026.05.001
UR - https://europepmc.org/article/MED/42923290
AB - Background and aims Colonic lipomas are benign tumors arising from mature adipose tissue and are usually asymptomatic; however, they can occasionally lead to adverse events, such as intussusception, abdominal pain, and GI bleeding. Colonic lipomas can be removed using a variety of endoscopic techniques, including endoscopic unroofing, loop-assisted resection, EMR, and endoscopic submucosal dissection (ESD). However, symptomatic lipomas are often large, and the visualization of the lipoma base during resection is difficult, rendering treatment challenging. Here, we report a case series of patients with large colonic lipomas who underwent underwater ESD (U-ESD).Methods Between April 2024 and March 2025, 4 patients with symptomatic or large colonic lipomas (≥30 mm), which were identified during colonoscopy, underwent U-ESD at our center.Results The buoyancy-based underwater technique provided continuous countertraction enhanced the visualization of the lesion base, and improved exposure of the dissection plane. In all 4 cases, lesions were safely and efficiently resected by U-ESD.Conclusions U-ESD may be considered a useful approach for the endoscopic resection of large colonic lipomas.
SN - 2468-4481
ER -