Art in Endoscopy: Tunnel “delivery” of a large esophageal leiomyoma

A 42-year-old man complaining of dysphagia was diagnosed as having an esophageal leiomyoma, about 3.3 × 1.7 cm in size and originating from the muscularis propria (4th layer). Submucosal tunneling endoscopic resection (STER) was the optimal option for the patient. A submucosal bleb was created 5 cm proximal to the lesion and the tunnel opening was incised. This was followed by dissection on either side of the lesion and dissection through the muscle, until the lesion was totally separated and “delivered” through the tunnel. The opening was then closed with endoclips.

Shaimaa Elkholy, Kareem Essam, Khaled Ragab, Dalia Abd El-Kareem, Mohamed El-Sherbiny Cairo University, Cairo, and Theodor Bilharz Research Institute, Giza, Egypt

Fig. 1 After submucosal tunneling endoscopic resection (STER) with complete separation of the lesion, a large esophageal leiomyoma is “delivered” through the submucosal tunnel opening.

Publication History

Article published online:
27 July 2021