WEO Video: Dr. Horst Neuhaus and Dr. Hinori Yamamoto
Dr. Horst Neuhaus from Germany and Dr. Hinori Yamamoto from Japan discuss and demonstrate the evaluation and removal of an early gastric cancer by endoscopic submucosal dissection
A symptomatic lipoma was found in the sigmoid colon of a 65 year old patient. Surgery had been suggested but an attempt was made to remove the lipoma endoscopically. Any attempt to cut across a large lipoma may be dangerous because the fatty tissue dissipates heat very quickly when cutting across the mucosa and this may result in a deep burn which can cause a perforation of the bowel. Here, an attempt was made at denuding the lipoma by capturing a portion of the mucosa and cutting it off. An attempt at squeezing the lipoma was made to extricate it through this mucosal defect, but this was unsuccessful. Further portions of mucosa were then resected until the lipoma itself was exposed sufficiently to be able to cut it off in piecemeal fashion. Cutting across the lipoma itself is relatively quick as opposed to cutting across the mucosa since the heat from the electrocautery snare is conducted away by the fat. The procedure demonstrated in this video has resulted in a marked reduction in the size of the lipoma. Only a small portion was left which will heal and result in curing the symptoms.
This procedure was performed at the Evangelisches Krankenhaus in Düsseldorf, Germany under the direction of Dr. Horst Neuhaus.