ASGE/JGES Advanced ESD (Live and Virtual) | July 16-17 2023-7-17-23 Lab Hands-On Virtual Demonstration Part 5

Video Transcription

Video Summary

In this video, Dr. Norio Fukami and Dr. Makoto Nishimura discuss the tunneling method in endoscopic submucosal dissection (ESD). They demonstrate how the tunneling method can be used in difficult cases or for lesions located in the colon. The tunneling method involves creating a straight line pocket to access the submucosal space and utilizing natural traction within the tunnel. The doctors discuss their personal experiences with using the tunneling method and mention that they sometimes combine it with a modified pocket creation method. They also discuss the importance of proper knife selection and adjusting the length of the knife based on the thickness of the tissue being treated. The speedboat knife, a bipolar knife with a tapered shape and a 4mm length, is used in the demonstration. Dr. Fukami and Dr. Nishimura explain the technique for using the speedboat knife to perform a mucosal incision and dissect the submucosal layer. They emphasize the need to be cautious to avoid accidental cuts, especially when pushing too deep into the muscle layer. Throughout the video, the doctors answer questions from the audience and provide insights into the effectiveness and limitations of the tunneling method and the speedboat knife. Additionally, they briefly demonstrate the use of a rubber band traction device called the short trap. The doctors conclude by discussing post-resection vessel coagulation and the decision to close the site depending on the patient's risk factors. Overall, the video provides valuable information and practical tips for performing ESD using the tunneling method and the speedboat knife. No credits are mentioned in the video.

Asset Subtitle

Suture
Norio Fukami, MD, MASGE
Sergey Kantesvoy, MD, FASGE

Keywords

tunneling method

endoscopic submucosal dissection

ESD

colon

submucosal space

natural traction

modified pocket creation method

knife selection

speedboat knife

mucosal incision