Endoscopic Submucosal Dissection in Colon and Rectum

The widespread adaptation of colorectal cancer screening programs causes a remarkable decrease in colorectal cancer-related death, meanwhile, there is an increase in diagnosis of early-stage rectal cancer and non-malignant polyps. Many patients with polyps are referred to surgery and more than 30,000 patients undergo surgical resection annually in the USA. Furthermore, the final pathology of such resections typically reports benign polyps with inevitable organ loss. Moreover, such surgical resections may encompass significant morbidity and mortality. On the other hand, advanced endoscopic interventions have significantly advanced and are gaining popularity due to low morbidity and mortality and also providing organ preservation. Advanced endoscopic procedures have the potential to develop even further. There are recent papers reporting initial successful and feasible incorporation of robotic systems for submucosal dissection. These developments will contribute to evolvement from endoscopic submucosal dissection to endorobotic and endoluminal surgery. This manuscript aims to discuss endoluminal surgery for colorectal lesions and its future directions.