Services

• Diagnostic Upper GI Endoscopy, Gastroscopy
• Diagnostic Lower GI Endoscopy, Colonoscopy
• Diagnostic Enteroscopy

Therapeutic Upper GI Endoscopy

• Esophageal Stricture Dilatation
• Esophageal Variceal Band Ligation
• Esophageal Polyp Removal
• Gastric Variceal Glue Injection
• APC for Gastric Telangiectasias
• Peptic Ulcer Disease Endoscopic Treatment
• Foreign Body Removal
• Percutaneous Endoscopic Gastrostomy
• Balloon Dilatation for Gastro Outlet Obstruction
• Esophageal Metal Stenting for Advanced Malignancy
• Gastric and Duodenal Stenting for Advanced Malignancy
• Endoscopic Bariatric Balloon Placement

Therapeutic Lower GI Endoscopy (Colonoscopy)

• Colonoscopic Polypectomy
• Colonic Balloon Dilatation
• Colonic Decompression for Colonic Psuedo Obstruction

Interventional ERCP

• Removal of Bile and Pancreatic Duct Stones
• Pancreatic and Bile Duct Stenting
• Intraductal Cholangio-Pancreatoscopy for Large Bile Duct and Pancreatic Duct Stones

Interventional EUS

• Diagnosis and staging of Malignancy, Tissue Diagnosis by FNAC / FNAB
• Pancreatic and Bile Duct Drainage
• Pancreatic Fluid Collection Drainage

Third Space Endoscopy

• POEM
• Endoscopic Mucosal Resection
• Endoscopic Submucosal Dissection

Endoscopic Submucosal Dissection

Endoscopic Submucosal Dissection (ESD) is an advanced, minimally invasive endoscopic technique used to remove large or high-risk precancerous lesions and early-stage cancers from the gastrointestinal (GI) tract, including the esophagus, stomach, colon, and rectum.

Unlike standard polypectomy or Endoscopic Mucosal Resection (EMR), ESD allows for en bloc (single piece) removal of deeper and more complex lesions with greater precision, reducing the risk of recurrence and enabling accurate histological assessment.

Why is ESD done?

ESD is primarily indicated for:

• Early gastrointestinal cancers confined to the mucosa or superficial submucosa
• Large or flat polyps not amenable to standard removal
• High-grade dysplasia in Barrett’s esophagus or stomach
• Recurrent lesions after previous incomplete resection

Benefits of ESD:

• Complete, en bloc resection of large lesions
• Organ-preserving – no need for open surgery
• Lower recurrence rate compared to piecemeal resection
• Accurate pathological assessment for cancer staging
• Minimally invasive with faster recovery

How is ESD performed?

• The procedure is done using a high-definition flexible endoscope.
• A special solution is injected beneath the lesion to lift it from the deeper layers.
• Precise dissection of the submucosal layer is done using advanced endoscopic knives.
• The entire lesion is removed in one piece (en bloc) for optimal histological evaluation.

Is it safe?

ESD is safe when performed by trained specialists. As it is technically more demanding than standard procedures, it may carry a slightly higher risk of:

• Bleeding
• Perforation

However, most complications are rare and can be managed during the procedure itself.

Aftercare:

• Patients may require short hospitalization for monitoring.
• Dietary adjustments (liquid or soft diet) are recommended for a few days.
• Your gastroenterologist will provide guidance based on biopsy results and follow-up requirements.

ESD is a cutting-edge technique offering curative treatment for select early cancers and advanced lesions of the GI tract—avoiding the need for major surgery while preserving the function of the digestive system.