Tunnel removal of a submucosal tumor in the esophagus (SET technique)
A submucosal tumor was diagnosed in the mid-esophagus as an incidental finding in this patient. The lesion was progressing over time.
Endoscopic ultrasound (EUS) showed that the tumor was 22 mm long and 14 mm wide. Contact with the muscularis could not be definitely excluded.
In this case, the indication was based on the lesion’s progression, EUS, and the patient’s desire for treatment. In view of the lesion’s size, EUS follow-up would also have been an acceptable alternative.
Submucosal injection of a methylene-stained saline solution and incision of the mucosa using the Olympus TT knife.
Dissection of the submucosal tunnel.
Capsule-protecting tumor dissection and release of the tumor from the muscularis layer.
Mobilizing the tumor out of the muscularis layer.
At the end of the procedure, another switch is made to the Olympus IT Nano Knife to release the tumor from the muscularis.
Demonstration of the excision area and closure of the mucosal entry site — histology: GIST.