ASGE/JGES Advanced ESD (Live and Virtual)| July 14-15 2023-7-15-23 Bring Your Case 4

Video Transcription

Video Summary

In this video, a 93-year-old female patient with rectal bleeding and a large rectal mass is discussed. The speaker describes the characteristics of the mass, including its size, type, and location. The speaker then explains the process of performing an endoscopic submucosal dissection (ESD) to remove the mass. During the procedure, the speaker encountered a large artery and sought advice from attendees on how to handle it. Different options are discussed, including using a coagulasper or a knife with low current density. The speaker decided to isolate the arteries using clips and coagulate them to avoid massive bleeding. The importance of observing blood vessel pulsation and color after coagulation is emphasized. The speaker shares a picture of the anatomy of the artery to illustrate the dissection plane. The use of clips to stop bleeding and prevent retraction is praised, and the speaker explains the technique of capturing part of the muscle layer with the clip. The procedure is successfully completed, and the patient goes home the same day without any bleeding. The specimen is confirmed to be a moderately differentiated invasive adenoma, and the resection is deemed curative. The video concludes with the speaker inviting any final questions or comments.

Keywords

rectal bleeding

rectal mass

endoscopic submucosal dissection

artery handling

coagulation