Colonoscopy:Ascending Colon Resection after two prior failed resections

Lesion: Subtle flat lesion (required chromoendoscopy and near focus imaging to define it). Previously resected and then ablated with a BICAP.
Location: Proximal ascending colon
Cap fitted colonoscope - adult scope: Cap helps to check the area better by moving folds or flattening folds; latest adult endoscope with near focus function helps to define the lesion and its extent.
Optical Diagnosis: Adenoma
Injection: Saline with Methylene Blue 8cc; Note: Inject away from the scar.
Submucosal injection lift: Good towards the IC valve; not so good towards the anus side on 2nd injection.
Snare: Select a small snare in tough resections as the lesion tends to slip out due to underlying scar tissue (used a 10 mm snare)
Electrocautery: Endocut Q 3-1-3; three cuts
Hot biopsy avulsion: Endocut I 2-1-1
Check the resection site with serial photos using a biopsy forceps if need be to flatten the area for better examination.
APC: 0.8lts, 35 W, Forced
Clip closure: 5 clips