Endoscopic Submucosal Dissection (ESD) in Bangladesh

What is ESD?

ESD stands for Endoscopic Submucosal Dissection. It is a specialised endoscopic technique used to remove larger pre-cancerous lesions or early cancers from the gastrointestinal tract. Using an endoscope, the lesion is dissected from the deeper layers of the bowel wall so that it can be removed in one piece (en-bloc) and examined by a pathologist.

When may ESD be considered?

ESD may be considered for certain larger or flat lesions — such as some early cancers and specific types of polyps — where removal through endoscopy may be possible instead of open surgery. Whether ESD is appropriate depends on the type, size and location of the lesion and on each patient's overall condition, test findings and clinical assessment.

ESD and EMR — what is the difference?

Both EMR (Endoscopic Mucosal Resection) and ESD remove lesions endoscopically. EMR is generally suitable for some smaller lesions, while ESD may allow larger or flatter lesions to be removed in one piece. The choice between them depends on each lesion and patient — a specialist decides after assessment.

Why specialised training matters

ESD is a technically demanding procedure. Performing it safely requires appropriate technology, specialised instruments, structured training and an experienced clinical team. International training and hands-on experience are therefore an important part of ESD practice.

Dr. Mohammad Naymul Hasan's verified ESD training includes an ASGE Fellowship in ESD (Japan) — with higher ESD training at the National Cancer Centre, Tokyo — followed by continued international ESD workshops and hands-on training. His practice reports completing 30 ESD procedures as a milestone, and ESD is performed as part of his advanced endoscopy practice.