Endoscopic and histologic images of Barrett's esophagus with early cancer treated with a combination of endoscopic resection and radiofrequency ablation using the Barrx system

(A) Antegrade view of Barrett's esophagus.
(B) A lesion suspicious for early cancer is noted from the 7-11 o'clock positions and delineated with electrocoagulation markers before starting the endoscopic resection procedure.
(C) View of the esophagus after en-bloc endoscopic submucosal dissection of the lesion.
(D) Histopathologic evaluation of the specimens showed a radically resected adenocarcinoma infiltrating the submucosa (T1sm1 G2 LV1).
(E) Same area six weeks after endoscopic resection showing that the wound has healed with mostly Barrett's mucosa and is still containing a small unhealed area.
(F) Esophagus after primary circumferential ablation using the Barrx Express system (1×10 J/cm² – clean – 1×10 J/cm²).
(G) Residual Barrett's mucosa six weeks after prior circumferential ablation.
(H) After additional focal ablation of the residual Barrett's segment, complete eradication was achieved.