On February 19, 2025, the Gastroenterology and Endoscopy Center at Makati Medical Center successfully performed its first Endoscopic Submucosal Dissection (ESD). The procedure was expertly carried out by Marc Julius H. Navarro, MD (Advanced Luminal and Third-space Endoscopist), with the invaluable support of Kirsten De Guia-Fernandez, MD (Anesthesiologist), and Natasha Abela-Mapa, MD (Gastroenterology Fellow).
ESD, an advanced endoscopic technique, is a minimally invasive procedure designed to remove large, complex, or early-stage cancerous lesions from the upper and lower gastrointestinal tract. The procedure involves high-definition endoscopy to identify the lesion, followed by the injection of a solution beneath the lesion to lift it from the surrounding tissue. A specialized electrosurgical knife is then used to carefully dissect the lesion en bloc (as a whole), which reduces the risk of recurrence and preserves the surrounding healthy tissue. ESD offers a promising alternative to surgery for patients with early-stage cancers and significantly contributes to more effective cancer screening and treatment.
The procedure was performed on a 59-year-old inpatient who was undergoing screening colonoscopy, during which a 5.0 cm laterally spreading mass was detected. Thanks to the coordinated efforts of our skilled Endoscopy team, the patient tolerated the procedure well and was discharged after 2 days, uneventful. Histopathology confirmed curative resection of tubulovillous adenoma with high-grade dysplasia and focus of intra-mucosal adenocarcinoma with negative horizontal and vertical margins rendering the patient essentially cancer-free.
This milestone highlights the center’s ongoing commitment to providing high-quality, innovative, and safe gastroenterological care. Moving forward, the center is excited to offer more ESD procedures, further reducing colorectal cancer cases and providing a safe, minimally invasive option for patients at high surgical risk.
