Process of Tunnel Establishment and Anatomic Marks Within the Tunnel

Abstract

Process of tunnel technique for lesions from mucosa, muscularis propria are discussed first and then the anatomic marks within the tunnel. It is often argued that it is difficult to keep orientation and distinguish the mucosal layer from the muscularis propria layer during establishment of a submucosal tunnel, the reason might be that the submucosal tunnel is an artificial cavity and its anatomy is not well understood. In this chapter the anatomic marks to be discussed are those being commonly used when performing tunnel technique nowadays and surely would be more well understood in the future with the development of tunnel technique. The morphology within the tunnel is actually similar to that within the lumen of the esophagus and the cardia. Anatomic marks described in this chapter include the morphology of vessels, the location of vessels, the morphology of the tunnel cavity and the characteristics of the muscle layer.