Endoscopic Submucosal Dissection: On the Rise from East to West

Charles J. Lightdale, MD, Consulting Editor

In the history of gastrointestinal endoscopy, every once in a while a new therapeutic method comes to the fore that seems difficult and risky, yet so elegant and dramatic in its benefits and possibilities that it fires the desire of interventional endoscopists worldwide to perform it. One such technique is endoscopic submucosal dissection (ESD), the subject of this issue of the Gastrointestinal Endoscopy Clinics of North America . ESD has been developed in Japan and is now rapidly spreading around the globe. The initial indication was to resect early gastric cancers en bloc to decrease recurrence. From there, ESD has been utilized from the esophagus to the colon for en-bloc resection of early cancers. The procedure has also opened up the submucosal space for other therapeutic measures, including resection of subepithelial tumors, and most notably for per-oral endoscopic myotomy for achalasia. Other variations useful for natural orifice transluminal endoscopic surgery are being perfected.

We can only be grateful to the Japanese innovators who have so generously given their time and effort to train a first wave of international practitioners of ESD. During the Peter D. Stevens Course on Innovations in Digestive Care at the New York-Presbyterian Hospital in 2012, I stood next to a young master endoscopist, Norio Fukami, from the University of Colorado, as he performed an ESD procedure in a live demonstration with a calm ease that took my breath away. That same day I asked if he would be willing to be guest editor for an issue of the Gastrointestinal Endoscopy Clinics of North America on ESD, and he immediately accepted. He has gathered an extraordinary group of pioneering experts from Japan as well as others from the United States and Europe to produce a landmark volume (with videos) on ESD, which should be pored over and treasured as the premier and comprehensive guide to this important new method in therapeutic gastrointestinal endoscopy.

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