Endoscopic intermuscular dissection (EID) of a severely fibrotic benign rectal lesion in an area affected by radiation proctitis

The rectum is the ideal part of the large bowel in which to perform deep excision for dysplastic lesions [11] [22]. However, in cases of severe submucosal fibrosis and deep invasion of a carcinoma into the submucosa, performing endoscopic submucosal dissection can be very difficult. The intermuscular plane of dissection and myectomy of the inner muscular layer (endoscopic intermuscular dissection) previously have been described for treatment rectal neoplastic lesions, overcoming the compactness of the submucosa layer [33] [44] [55].