Internal traction combined with underwater endoscopic submucosal dissection for a rectal neuroendocrine tumor

Underwater endoscopic submucosal dissection (ESD) has the advantages of a clear endoscopic view and easy manipulation by buoyancy in the removal of gastrointestinal tract lesions [1]. In addition, some cases reported that traction combined with underwater ESD improved visual acuity in the removal of early pharyngeal cancer and colorectal sessile serrated adenoma/polyp [2] [3]. Herein, we showed a case with a rectal neuroendocrine tumor (NET), which was successfully removed by internal traction combined with underwater ESD.