What does it indicate if a lesion fails to rise following saline injection?

When a lesion fails to rise following saline injection, it is indicative of submucosal involvement with the pathology. This means that the lesion may be rooted deeper than the mucosal layer, preventing the saline from creating the expected lift. Saline injection is often used in endoscopic procedures to elevate lesions, which allows for better visualization and assessment.

In cases where the saline does not induce elevation, it suggests that the lesion is likely attached to or infiltrating deeper tissues or structures, such as submucosa or even beyond, making it more challenging to remove or treat with traditional endoscopic techniques alone. This characteristic can be vital in guiding the approach for further evaluation, diagnosis, or management of the lesion. Thus, understanding this aspect is crucial for effective endoscopic surgical planning and decision-making.