Endoscopic Submucosal Dissection

Endoscopic submucosal dissection (ESD) is an advanced endoscopic procedure used to remove gastrointestinal tumors that have not entered the muscle layer.

In the gastrointestinal tract, the submucosa is the layer of dense irregular connective tissue or loose connective tissue that supports the mucosa (moist tissue that lines some organs and body cavities throughout the body), as well as joins the mucosa to the bulk of underlying smooth muscle (fibers running circularly within the layer of muscle).

The three step procedure includes:

  1. Injecting fluid into the submucosa to elevate the lesion
  2. Cutting the surrounding mucosa of the lesion
  3. Dissecting the submucosa beneath the lesion

The ESD procedure is performed in the Integrated Procedural Center in the Jones Pavilion.  The procedure is lengthy and can take between three and four hours. After the procedure, you may or may not be kept in the hospital for observation.

ESD is widely practiced in Asia and is growing in popularity in the United States. Because of the procedure’s technical difficulty, ESD requires highly skilled and specially trained endoscopists, like those within Virginia Mason’s Digestive Disease Institute.