What is third space? — the layer between mucosa and muscle. Creating a tunnel here lets us reach lesions without cutting through the wall.

Who benefits — Zenker’s diverticulum, achalasia (POEM) and early oesophageal cancers.

Procedure snapshot — mucosal incision → tunnel creation → tumour dissection → entry closure with clips; all via a 9 mm scope.

Outcomes — 98 % en-bloc resection, nil external scars, discharge same evening. Dr Chandu trained at AIMS Kochi’s advanced endoscopy unit to master this.

Future frontiers — robotic scopes and AI-guided margins promise even safer resections.