ASGE JGES Advanced ESD (On-Demand) | September 2022 OLESDSEPT22ADV-Case Study Discussion 2

Video Transcription

Video Summary

In this video, the presenter discusses a case involving a large lesion located at the hepatic flexure. The lesion is described as a 10 cm laterally spreading tumor granulotype. The presenter explains that they evaluate three factors before performing an endoscopic submucosal dissection (ESD) on such lesions: gravity, lesion stability, and scope access. They then discuss two techniques for facilitating difficult ESD: traction and pocket creation. The presenter chooses to start with the pocket creation method but encounters difficulties accessing the right side of the lesion due to the angle. They switch to using traction by placing a rubber band with dual clips on the backside of the lesion. The presenter demonstrates the dissection process, emphasizing the importance of avoiding muscle injury when using traction. They also discuss options for retrieving large resected specimens and addressing complications during the procedure. The video concludes by presenting the successful removal of a 10 cm specimen with multiple intramucosal cancers. Overall, the video provides insight into the challenges and techniques involved in performing ESD on large lesions. No credits were mentioned in the video.

Asset Subtitle

Hiroyuki Aihara, MD, PhD, FASGE, FJGES

Keywords

hepatic flexure

lesion

ESD

traction

intramucosal cancers