Hybrid endoscopic resection combining underwater endoscopic mucosal resection and over-the-scope clip–assisted snare polypectomy for a recurrent colonic tumor with a hidden diverticulum

Endoscopic treatment of recurrent or residual lesions after endoscopic resection is challenging because severe fibrosis causes their lack of elevation.1,2 Complete resection via conventional EMR is often difficult; furthermore, although endoscopic submucosal dissection is useful, it requires advanced techniques and long procedure times and entails the risk of perforation.3 Recently, over-the-scope clip (OTSC)-assisted snare polypectomy and full-thickness resection devices have been developed to treat these lesions.