Endoscopic submucosal dissection of a rectal carcinoid tumor using grasping type scissors forceps

Figure 3 Schematic shows ESD using GSF. Step 1: A concentrated glycerin solution mixed with a small volume of epinephrine and indigo carmine dye is injected into the submucosal layer around the target lesion to lift the entire lesion; Step 2: The lesion is separated from the surrounding normal mucosa by complete incision around the lesion using the GSF; Step 3: A piece of submucosal tissue is grasped and cut with the forceps using an electrosurgical current to effect submucosal exfoliation; Step 4: The lesion is resected in one piece. m: Mucosa; sm: Submucosa; mp: Muscularis propria; t: Tumor.