Endoscopic Submucosal Dissection (ESD)



Endoscopic submucosal dissection (ESD) has been performed in Japan for over 25 years. However, interest in ESD in Canada has only recently sparked and thus we are relatively late in its adoption compared to our international peers. The reason for this is multifactorial and includes the structure of our health care system, remuneration, lack of formal training available in North America and lack of knowledge in endoscopic diagnosis, etc. As such, for Canadian operators to “catch up” with the rest of the world and contribute to the field of ESD, we must work together and utilize our vast knowledge and expertise.


Primary Aims:


  1. Establish the status and practice in Canada
    1. Who is performing ESD? What training did they receive? What is their current and expected volume?
  2. Identify the current and expected obstacles
  3. Identify the current indications for which ESD is being performed
    1. Plan to establish a subcommittee with the goals of establishing evidence-based guidelines for Canada and submit for publication.
  4. Training
    1. Identify what training the current operators have undergone
    2. Establish what is the minimum required training required prior to performing ESD independently
  5. Remuneration
    1. Survey what current billing practices are for ESD
    2. Plan for future potential billing codes
  6. Attempt to unify the practice in Canada and disseminate knowledge and practical information
  7. Establish a forum discussion, presentation, and shared management of cases
  8. Creation of a national registry