ASGE/JGES Advanced ESD (Live and Virtual)| July 14-15 2023-Lab Hands-On Virtual Demonstration Part 3

Video Transcription

Video Summary

In this video, Naofisayo Hagi from Keio University demonstrates two traction techniques for endoscopic submucosal dissection (ESD): creep line traction and the water pressure method. Hagi explains that the gravity side, which is typically challenging for ESD due to difficulty in opening the submucosal space, was selected for demonstration. Hagi works with Dr. Kato, Dr. Saito, and Dr. Toyonaga. For the creep line traction technique, Hagi makes a circumferential mucosal incision and injects a submucosal fluid cushion to create a nice lifting sign. Using a dual knife, Hagi makes a submucosal dissection, focusing on the gravity side. The water pressure method is employed for the next target region. Hagi attaches an SD hood and fills the lumen with normal saline for better visualization. Hagi makes a mucosal incision and conducts submucosal dissection, utilizing the pressure of the normal saline. The remaining tissue is caught and dissected until completion. Hagi concludes by mentioning that the water pressure method is useful for regions where gravity does not work well, such as the duodenum and right side colon or cecum. The video provides insights into the ESD techniques and their application.

Keywords

endoscopic submucosal dissection

traction techniques

creep line traction

water pressure method

ESD

submucosal dissection

normal saline