Abstract Text
Endoscopic submucosal dissection (ESD) of the ileocecal valve (ICV) is technically demanding. We report a case of a laterally spreading tumor involving both lips of the ICV and extending 1 cm into the terminal ileum. After performing a circumferential underwater dissection with a colonoscope fitted with a conic hood, we adopted several strategies to prevent adverse events. These included intraprocedural coagulation of visible vessels and eversion of the ileal margin, which was then clipped to the distal colon to achieve a 180° closure. On the contralateral side, we applied a self-assembling peptide matrix. This approach avoided the creation of a circumferential defect and promoted optimal healing. No adverse events occurred, and at 1-year follow-up the ileocecal valve remained widely patent, with no evidence of stenosis.