To Tattoo or Not to Tattoo: A Gastroenterologist’s Guide to Endoscopic Tattooing

To Tattoo or Not to Tattoo: A Gastroenterologist’s Guide to Endoscopic Tattooing

Proper surveillance of colorectal cancer, the second most common form of cancer, is a crucial step in not just catching the disease early — but preventing it entirely.

Endoscopic tattooing is a valuable tool for surgical localization and to enable identification of malignant or suspicious lesions at a future colonoscopy.  However, without standardized regulations for the procedure, a lot of questions remain about when physicians should tattoo.

To clear things up, we’ve collected some general guidelines that help answer the question: to tattoo or not to tattoo?

When To Tattoo

The 2017 ESGE Guidelines For EMR and Polypectomy1 recommends that lesions be tattooed in the following circumstances:

  • Proven or suspected malignant
  • Polypectomy of lesions with potential cancer or piecemeal removal
  • Endoscopic mucosal resection (EMR)
  • Endoscopic submucosal dissection (ESD)
  • Difficult-to-detect polyps

When Not to Tattoo

Of course, while tattooing has proven to be an invaluable piece of surveillance and disease management for colorectal cancer, there are situations in which it is not recommended.  The 2017 ESGE guidelines also recommend that tattooing should be avoided if the lesion is definitely located in the:

  • Cecum
  • Adjacent to the ileocecal valve
  • In the low rectum

Using the right tool for the job is just as important as knowing when to use it. Spot® Ex is permanent with indications for surgical localization and clinical surveillance2 which helps you align routine clinical practice with the new guidelines and enables a lifetime of follow-up procedures and, hopefully, prevention.

Learn more about why, when, and how to effectively tattoo during colonoscopy procedures in the video below featuring Dr. Douglas K. Rex from Indiana University School of Medicine, and take the next step in the fight against colon cancer with the Spot Ex Endoscopic Tattoo.

Learn More About Spot® Ex

And don’t miss our easy-to-reference infographic with some fast facts on endoscopic tattooing to help spread the word. Get your copy here:

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1 – Ferlitsch M, Moss A, Hassan C, etal. Colorectal polypectomy and endoscopic mucosal reseaction (EMR): ESGE Clinical Guideline. 2017.
2 – Spot Ex Indication. Instructions For Use. G45-006 Rev02. Jan 2018.