ASGE Endoscopy Live: Colonoscopy Symposium (On-Demand) | September 2022-Endoscopy Live Case Demonstration 2

Video Transcription

Video Summary

In this video, Dr. Saito performs an endoscopic submucosal dissection (ESD) procedure on a large sigmoid colon polyp. The patient is a 40-year-old female with new-onset painless rectal bleeding. After initial colonoscopy and biopsy, the decision was made to proceed with ESD due to the size and appearance of the polyp. Dr. Saito demonstrates the pocket creation method, making incisions to create a tunnel around the polyp before dissecting it from the surrounding tissue. Throughout the procedure, Dr. Saito uses various tools, including the IT9 nano knife and the All-Rise Pro knife. He also discusses the use of different diathermy settings and techniques for managing bleeding. The procedure concludes with the application of a puristat solution to promote ulcer healing. Dr. Saito mentions that closure of the defect is not routinely performed, but may be considered in cases with muscle damage or high risk of bleeding due to anticoagulant use. The video provides insights into the ESD technique and highlights considerations for patient positioning, diathermy settings, and managing complications like bleeding.

Keywords

endoscopic submucosal dissection

ESD procedure

sigmoid colon polyp

rectal bleeding

colonoscopy

biopsy

pocket creation method

IT9 nano knife

bleeding management