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Submucosal Tunnelling Endoscopic Resection (STER)

STER is a minimally invasive endoscopic procedure used to remove tumors growing beneath the inner lining of the gastrointestinal tract — especially the oesophagus, stomach, or upper part of the small intestine.

It is often used for subepithelial (below the surface) tumors such as:

  •      Leiomyomas (benign muscle tumors)
  •      GISTs (gastrointestinal stromal tumors)
  •      Other benign or potentially cancerous tumors confined to the wall of the GI tract

Why is STER done?

Your doctor may recommend STER if:

  •     You have a tumor beneath the inner lining of the oesophagus or stomach.
  •     The tumor is growing, causing symptoms, or needs to be removed for diagnosis.
  •     A standard endoscopic or surgical approach would be more invasive or risky.

STER allows complete removal of tumors with no external cuts, preserving the normal function of the digestive system.

How is the STER procedure performed?

  •      You will receive general anaesthesia to keep you asleep and comfortable.
  •      A thin, flexible tube (endoscope) is passed through your mouth.
  •      A small cut is made in the inner lining (mucosa) of the GI tract.
  •      The doctor creates a tunnel beneath the lining, leading to the tumor.
  •      The tumor is carefully cut and removed through the tunnel.
  •      The entry site is closed with clips, which fall off on their own after a few weeks.

What are the benefits?

  •      Minimally invasive: no skin incisions
  •      Complete removal of deep-seated tumors
  •      Shorter hospital stay and quicker recovery
  •      Preserves the normal structure and function of the GI tract
  •      Less pain and scarring than traditional surgery

What are the risks?

Like all procedures, STER carries some risks:

Risk

Details

Bleeding

   Usually mild and controlled during the procedure

Perforation (tear)

   Rare, but can occur in the tunnel and may require further treatment

Infection

   Antibiotics are given to prevent this

Gas-related symptoms

   Temporary bloating, chest discomfort, or trapped air

Stricture (narrowing)

   Rare, may require additional endoscopic treatment

Incomplete removal

   Rare, but follow-up scans may be needed

What happens after the procedure?

  •      You'll be monitored in hospital for 1–2 days.
  •      You’ll be started on a liquid or soft diet, then gradually return to normal eating.
  • You will be prescribed:
      •     Antibiotics to prevent infection
      •     Acid-reducing medications to promote healing
  •      You’ll have a follow-up endoscopy or scan to ensure healing and no tumor remains.

Frequently Asked Questions

Q: Will I have a scar or incision?
A: No. STER is done entirely through the mouth, so there are no external scars.

Q: Is the tumor gone for good?
A: In most cases, yes. Your doctor will monitor you to ensure complete removal and check for recurrence.

Q: What will my recovery be like?
A: Most people recover quickly, with mild discomfort or bloating. Normal activities can usually resume in a few days.

Q: Is STER used for cancer?
A: STER is typically used for benign tumors or those with low cancer risk. If cancer is found, additional treatment may be needed.