Underwater endoscopic resection: an alternative for difficult colorectal polyps

BACKGROUND AND AIMS: Underwater endoscopic resection can be an alternative to standard resection techniques to remove difficult colorectal polyps. This video shows 4 cases of underwater resection of large colorectal polyps. METHODS: Underwater resection consists of complete filling of the lumen through the accessory channel, using an infusion pump followed by snare resection of the polyp. We present 4 cases: a 3-cm pseudodepressed laterally spreading tumor (LST) in the sigmoid colon, a 6-cm pedunculated polyp with a thick stalk in the sigmoid, a 7-cm sessile lesion in the midrectum, and a 4-cm LST in the distal rectum close to the dentate line, resected with a monofilament snare or a multifilament snare. RESULTS: All tumors were successfully resected without any adverse events or residual lesions during follow-up. CONCLUSIONS: The underwater technique is a good alternative to standard resection techniques to remove difficult colorectal lesions.