A bipolar device was useful in ESD of a large type 0-I tumor in the ascending colon

A CT scan after bladder cancer treatment in a male in his 80s showed a large tumor in the ascending colon. Colonoscopy revealed a 50-mm 0-I tumor. Endoscopic mucosal resection was difficult because of the short stalk and the huge size of the apex. We therefore performed endoscopic submucosal dissection (ESD) using a bipolar device. By clipping the stalk and dissecting just above it, we could resect the lesion en bloc without complications. The pathology findings were 50×48 mm, tub1 (carcinoma in adenoma), pT1a (M), ly0, v0, HM0, VM0.