Multiple traction band—assisted endoscopic submucosal dissection of a giant colorectal lipoma after unsuccessful unroofing

Q3 Medicine

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-27 DOI:10.1016/j.vgie.2026.03.003

Hiroshi Yamazaki MD, Yohei Minato MD, Koichi Furuta MD, Shinya Nagae MD, Nao Takeuchi MD, Ryoju Negishi MD, Hideki Chiba MD, PhD, Ken Ohata MD, PhD

{"title":"Multiple traction band—assisted endoscopic submucosal dissection of a giant colorectal lipoma after unsuccessful unroofing","authors":"Hiroshi Yamazaki MD, Yohei Minato MD, Koichi Furuta MD, Shinya Nagae MD, Nao Takeuchi MD, Ryoju Negishi MD, Hideki Chiba MD, PhD, Ken Ohata MD, PhD","doi":"10.1016/j.vgie.2026.03.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Aims</h3><div>Large colorectal lipomas can cause symptoms such as abdominal pain, bleeding, and intussusception. Despite increasing reports of endoscopic treatments, endoscopic resection of large lipomas remains technically challenging. Here, we report a case of successful endoscopic submucosal dissection (ESD) using multiple traction bands for a large lipoma after failed unroofing.</div></div><div><h3>Methods</h3><div>A 55-year-old woman with chronic abdominal pain had a 70-mm submucosal tumor in the ascending colon, confirmed to be a lipoma. Initial unroofing failed because of poor electrical conductivity of the lipoma. Two months later, with the patient having persistent symptoms and a remaining 50-mm lipoma, ESD was performed. Multiple traction bands were clipped between the lipoma and the contralateral wall to lift the tumor and improve visualization.</div></div><div><h3>Results</h3><div>ESD was successfully performed using multiple traction devices applied sequentially to maintain tension and visibility during dissection. The lesion was completely removed en bloc, and the defect was closed using the clip-with-line pulley–securing technique. Histology confirmed a benign lipoma. The patient remained symptom free with no recurrence at 1-year follow-up.</div></div><div><h3>Conclusions</h3><div>Multiple traction–assisted ESD is a safe and effective approach for large colorectal lipomas, enabling minimally invasive resection while reducing the risk of perforation and recurrence.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 356-358"},"PeriodicalIF":0.0000,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"VideoGIE","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468448126000603","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/3/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Aims

Large colorectal lipomas can cause symptoms such as abdominal pain, bleeding, and intussusception. Despite increasing reports of endoscopic treatments, endoscopic resection of large lipomas remains technically challenging. Here, we report a case of successful endoscopic submucosal dissection (ESD) using multiple traction bands for a large lipoma after failed unroofing.

Methods

A 55-year-old woman with chronic abdominal pain had a 70-mm submucosal tumor in the ascending colon, confirmed to be a lipoma. Initial unroofing failed because of poor electrical conductivity of the lipoma. Two months later, with the patient having persistent symptoms and a remaining 50-mm lipoma, ESD was performed. Multiple traction bands were clipped between the lipoma and the contralateral wall to lift the tumor and improve visualization.

Results

ESD was successfully performed using multiple traction devices applied sequentially to maintain tension and visibility during dissection. The lesion was completely removed en bloc, and the defect was closed using the clip-with-line pulley–securing technique. Histology confirmed a benign lipoma. The patient remained symptom free with no recurrence at 1-year follow-up.

Conclusions

Multiple traction–assisted ESD is a safe and effective approach for large colorectal lipomas, enabling minimally invasive resection while reducing the risk of perforation and recurrence.

查看原文本刊更多论文

巨大结直肠脂肪瘤去顶失败后多次牵引带内镜下粘膜下剥离术

背景和目的大的结直肠脂肪瘤可引起腹痛、出血和肠套叠等症状。尽管内窥镜治疗的报道越来越多，但内窥镜切除大脂肪瘤在技术上仍然具有挑战性。在此，我们报告一例成功的内镜下粘膜下剥离（ESD），使用多个牵引带对一个大的脂肪瘤后失败的打开。方法一例55岁女性慢性腹痛患者在升结肠黏膜下发现一个70 mm的肿瘤，证实为脂肪瘤。由于脂肪瘤的导电性差，最初的去顶失败。2个月后，由于患者症状持续，且仍有一个50毫米的脂肪瘤，我们进行了ESD手术。在脂肪瘤和对侧壁之间夹入多个牵引带，以提升肿瘤并改善视觉。结果连续使用多个牵引装置保持解剖过程中的张力和可视性，成功完成esd手术。病灶全部切除，并用夹带线滑轮固定技术闭合缺损。组织学证实为良性脂肪瘤。随访1年，患者无症状，无复发。结论多重牵引辅助下的ESD是一种安全有效的治疗大肠癌脂肪瘤的方法，可以实现微创切除，同时降低穿孔和复发的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.