Successful endoscopic submucosal dissection for a cecal laterally spreading tumor using a motorized spiral enteroscope in a case with difficult intubation

In colorectal endoscopic submucosal dissection (ESD), it is essential to intubate with the endoscope in a straight position and maintain stable maneuverability during the procedure. It is however often difficult to obtain these good conditions, especially in patients with colon elongation, poor fixation, or severe obesity. Recently, a motorized spiral enteroscope (MSE) was launched [1] [2] [3] ([Fig. 1]). MSE enables deep intubation and appropriate fixation by rotation of the fins around the scope to squeeze the intestinal tract. Here, we report a very challenging cecal ESD in which the MSE was extremely useful ([Video 1]).