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  • And a circumferential submucosal cut is first made using fine movements and maneuvers, the needle knife is passed through the viagra online cheap canada instrument channel of the scope. The specimen is immediately mounted onto Styrofoam with pins and oriented for pathologic examination. The borders of the lesion are defined using NBI or adding a dye to the surface of the lesion. It can be retrieved with a Roth net or spider net, once the lesion is freed from the base. Subsequently, the viagra online cheap canada base of the lesion is dissected with multiple cuts.

    Multiple submucosal injections are needed as the submucosal cushion tends to dissipate with time. Even though various modified needle knives are available, only the conventional (straight fine tip with regulated length) needle knife is commercially available in the United States. The lesion is located and raised with submucosal injections.

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