ASGE Endoscopy Live: Colonoscopy Symposium (On-Demand) | September 2022-Endoscopy Live Case Demonstration 4

Video Transcription

Video Summary

In this video, Dr. Kashab at Johns Hopkins Hospital is demonstrating an endoscopic mucosal resection (EMR) of a medium-sized polyp. The patient is an 85-year-old female who presented with painless rectal bleeding. The polyp is a 30-millimeter Paris-class 02A tubular adenoma in the ascending colon. The procedure begins with an Olympus adult colonoscope with GI Genius from Medtronic activated, which detects a small polyp. Dr. Kashab proceeds with the EMR using a lift and snare technique, followed by soft coagulation of the edges to prevent bleeding. He demonstrates the use of PureStat, a transparent peptide gel, on the bed of the EMR to prevent delayed bleeding. To close the resection site, Dr. Kashab uses the Apollo through-the-scope suture system called XTAC. He places four helical tags around the lesion, ensuring they are in the muscle layer. The tags are deployed and rotated to secure them properly. The final step is cinching the sutures to close the resection site. The video concludes by mentioning that XTAC can be used for large defects and complex closures, such as after ESD procedures. Dr. Kashab and his colleagues highlight the benefits of the XTAC system, including its ease of use and potential for reducing post-procedural bleeding.

Keywords

endoscopic mucosal resection

EMR

polyp

Paris-class 02A

colonoscope

XTAC

post-procedural bleeding