Effectiveness of water pressure method in colorectal endoscopic submucosal dissection by novice endoscopists

Background and Aims: Colorectal endoscopic submucosal dissection (ESD) remains challenging for novice endoscopists. Not only underwater conditions but using active water pressure, pressure method (WPM) can help widen the layer. This study aimed to clarify usefulness of WPM in colorectal ESD, especially Methods: was ex vivo study, which enrolled three novices. Each endoscopist performed conventional ESD (C-ESD) with (WPM-ESD) 10 times on excised bovine rectum. The treatment outcomes were compared between two groups. Results: Median procedure time significantly shorter WPM-ESD group than C-ESD (54 [interquartile range {IQR}, 42–67] vs. 45 [IQR, 34–55] min, p = 0.035). Although no significant difference activation electrical surgical unit (ESU) during noted, interval at ESU not activated (52 40–65] 42 32–52] 0.030) group. Moreover, required endoscope enter submucosa (8.0 6.0–10] 5.0 3.0–6.0] < 0.001). Conclusion: present reveals that shortens refers spent creating field view, submucosa.