Deconstructed ESD — Day 1, Lower GI

Deconstructed ESD — Day 1: Lower GI

Wednesday 18 November 2026 · UZ Gent, Belgium · live from the endoscopy rooms

ESD is usually taught as one continuous technique. Over two days at UZ Gent we take it apart. Day 1 is colorectal: every case is worked through the same sequence of decisions — how the lesion is assessed before a knife is picked up, where the EID goes if the resection has to be oncologically sound, how traction is set up and when it is worth the time it costs, and what to do when the plane runs out and the resection becomes knife-assisted full-thickness.

What is demonstrated

• Lesion assessment and the decision to proceed — SMI risk, LST morphology, when ESD beats EMR
• Oncological placement of the EID
• Submucosal traction — set-up, cost in time, when it earns its place
• Rat-tooth technique on scarred and recurrent lesions
• Knife-assisted full-thickness resection — the bail-out when the plane disappears

Two techniques at the centre

• Saline immersion — dissecting under saline: buoyancy opens the submucosal space, the view stays clear, and haemostasis is more controlled.
• REACT multipoint traction — the repositionable elastic traction system developed at UZ Gent (react.gieqs.com; Gastrointestinal Endoscopy 2025, 59 consecutive colorectal ESDs). Built from low-cost elastic bands and re-openable clips, adjusted as the dissection progresses.

Hands-on, assessed on video

Every hands-on case is recorded and scored with the ESD-CAT, the new ESD competency assessment tool (live and video modes, entrustment-anchored, built on the ESGE ESD curriculum). Participants leave with a structured assessment of their own case, not just a certificate.

Faculty

• Prof. Edward J. Despott — Royal Free Unit for Endoscopy, Royal Free London / UCL
• Dr Nima Mottacki — Sahlgrenska University Hospital, Gothenburg
• Prof. David J. Tate and the UZ Gent tissue-resection team

Format

Live cases transmitted from two endoscopy rooms with faculty commentary, short lectures between cases, and video review of the morning's resections over lunch. Day 2 (Thursday 19 November) covers upper GI.

Who it is for

Endoscopists performing EMR and building towards ESD, and ESD operators who want the component skills isolated.

Attendance

Option	Per day	Places
Virtual (live stream + catch-up)	Register on this page	Open
Live, observer	€100	10
Live, hands-on	€250	6

Hands-on places require prior agreement on preparation. For live attendance or a hands-on place, email [email protected].

RIZIV/INAMI accreditation has been applied for. With the support of Fujifilm, Pentax and Olympus.