ASGE Endoscopy Live: Colonoscopy Symposium (On-Demand) | September 2022-Endoscopy Live Case Demonstration 8

Video Transcription

Video Summary

In this video, Dr. Nam and Dr. Saito from Johns Hopkins perform a flexible sigmoidoscopy with endoscopic submucosal dissection (ESD) on a 58-year-old female patient with a history of mental health disability and a previous rectal polyp removal. The patient had a large 30mm recurrent polyp with a central scar. The procedure is performed with the goal of complete resection of the polyp while avoiding deep invasive cancer. The doctors encounter challenges with severe submucosal fibrosis and significant bleeding during the procedure but are able to successfully complete the ESD. They discuss various techniques and tools used during the procedure, such as injection of heterostats mixed with methylene blue, endoclot, and snare. They also consider other options like full-thickness resection using the FTRD device or a surgeon's transanal approach. Throughout the video, they provide explanations and commentary, addressing challenges and discussing their strategies and decisions. The doctors also mention using cryo coagulation, a spray called hemo spray for wound coverage, and closing the resection area with X-tab and regular clips. The video concludes with the doctors discussing the plan for follow-up care and mentioning the benefits of closing the resection area to prevent complications. No credits are mentioned.

Keywords

flexible sigmoidoscopy

endoscopic submucosal dissection

recurrent polyp

submucosal fibrosis

bleeding

follow-up care