Selective ESD: En Bloc When It Changes Management
The discipline of selection, argued before the audience watches the service run. Colon-focused by design — outside the colon the case for en bloc largely makes itself.
Running order (indicative)
- Head
- Dr Lobke Desomeranchors the studio throughout
- Talk 1
- Dr Amyn HajiEn Bloc in the Colon: Where It Genuinely Changes Management
- Talk 2
- Dr John AndersonTrain, Refer or Host? Deciding Whether ESD Belongs in Your Centre
- Live case
- Prof David TateDr Andrea SorgeAdvanced submucosal ESD chapter (rectum / stomach / oesophagus)
- Discussion
- Allremaining session time
The session, as written
Lecture 1 — En bloc in the colon: where it genuinely changes management. (Haji). The honest map: where en bloc changes the pathway, where EMR answers the question at a fraction of the cost — and where underwater EMR sits in between: increasingly used for benign disease, never for invasive.
Lecture 2 — Train, refer, or host? (Anderson). The case against ESD in every unit, said out loud — why the small-hospital ESD service is usually a bad idea — and the honest alternatives: train up, refer out, or host in. Centralised referral with selective training, a network that makes "not here" a strength rather than a failure.
Live case — an ESD chapter. A dissection shown as teaching chapters — strategy, traction, haemostasis — with the selection reasoning and the surgical alternative made explicit.
