Endoscopic intermuscular dissection of an undetermined submucosal lesion with adaptive traction to obtain a free vertical margin

Endoscopic submucosal dissection (ESD) is a well-established technique for resecting superficial gastrointestinal neoplasms [1]. However, achieving clear vertical margins for submucosal lesions, such as neuroendocrine tumors, can be intricate [2]. The endoscopic intermuscular dissection (EID) method, which involves dissection between the two muscular layers of the rectum, was first developed to treat superficial tumors with vertical extension (T1) [3]. We think this technique could be useful to obtain free vertical margins for submucosal tumors.