Now, Dr. Yamamoto is changing to this food, but they are changing to their original Small Cal Reaver clear food. Yes, and I would like to show you the technique of how to create pockets. thank you. My assistant, Dr. Muller, puts the cap on this Smolika Reaver. Today I will show you how to create pockets. It is located at the bottom of the ground. In that case, gravity cannot be used to open the wound. Instead of using gravity, use voyancy. So I use S-D and water, actually S-D at the bottom of the sail line. When I use this SD head, I use a lens cleaner. Lens cleaner is very important when going diving. That way you won't be able to see well. Yes, inside and outside. This water is a bit dirty, so you'll want to suck it up. This is the region. It's bigger than yesterday. Now let's do the injection. Today, we'll learn how to make a pocket and create a bridge shape by going through the distal side. In that case, make a Mikozaru seal on the distal side. Now let's do the injection. Make a Mikozaru seal. under the protrusion My assistant Mueller is controlling the device, but you can also do it yourself. In that case, I control the endoscope with my left hand. Control the endoscope and control the endoscope with your left hand. Then insert the endoscope. Then stop and move. Please inject. Pour 2 cc and 2 ml of water into each pancho. OK, stop. yeah? Now, let's use the flash knife used to cut the mucoser. Cut from the inside. Cut from the inside of the mucoser. Cut like this. Now, let's cut from the left side. What is the cutting time? I would like to increase the time by 4. And the interval is 1. Yes, the interval is 1. Yes, the interval is 1. You can choose any interval you like. I like rapid intervals. Remove the nail. keep the same position. The edge of the knife is inside the mucoser. Let's start cutting. Rotate the tip of the endoscope to the right and the knife will move to the right. In this situation. Depending on which angle you are using, the endoscope will rotate to the right and the knife will move to the left. This is the farthest point and you might cut in from this side. The point of the knife should be in the center. What knife is this connected to? Is this a flash knife? Is it outside? It's a hood. It's a hood. The flash knife... The cyst is in the center. The cyst should be on the outside, but the needle should be in the middle of the submucosa. The cyst should be outside the submucosa. You can see the marks on the knife. Make a cut on the outside of the knife mark. It is connected to the cutting line made from the left side. using a water grenade Inhale completely. Breathe in the air. and at the water surface Let's breathe in the air and create a base condition. Oh, it's so beautiful. Okay, so we can open it now. Then, if you trace the inside of the mucosa, you can cut out the mucosa of the muscle. in this way. Next, if you trace the inside of Myukosa, Muscle mucosa can be cut out. Next, by tracing the inside of the mucosa, you can cut out the mucosa of the muscle. Next, reduce the effect. I had effect 4, but I reduced the effect to 2. What happens then? 1、2、3、4、5、6、7、8、9、10、11、12、13、14、15、16、17、18、19、20、21、22、23、24、25、26、27、28、29、30、31、32、33、34、35、36、37、38、39、40、40、41、42、43、44、44、45、46、47、48、49、50、51、52、52、53、54、55、56、56、57、57、58、59、60、61、62、62、63、62、63、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62、62 Ah, 800 volts Select optimal conditions to reduce bubbles and cut. In this case, dry cut, effect 3, or maybe a little more expensive. It can be adjusted depending on the conditions. Anyway, open Mucoser and put Creation in from the aura side. Insert creation from the aura side. inject Hmm, how do we do that? Inject Oh, this is good. OK, nice. Will today's work be shaped like a bridge? Yes, it's in the shape of a bridge. make a pocket, Connect the back side and the inside to create a bridge shape. There are similar names, such as tunneling ESD and bridge shapes. The concept is to create a pocket. Yes, it's the same. OK, stop. Sometimes I connect on the backside. Either, You can easily use either. Stop. OK。 Stop. once again. once again. Connect. OK, stop. OK。 Let's take a look. This is Mark. This is Mark. Create the opening and closing here. It opens and closes with a width of about 2cm of Mikozari. OK。 No, this... Stop. Super Wig Wonder Water Morneau Acceptance 2 This is a mark, so it's a little larger than 2cm. This is ThriftQuarg. Please give me ThriftQuarg and Effect 4. I used a knife first. In this condition, I chose the underwater sailing technique. Breathe in air completely. And if you have a problem with bubbles under the water, then the next step is to use an end cut. The length of the end cut is 1. And you can see the muscles here. This aspect is similar. Is this a flash knife? The scope is on the right. Flash on the left? Yes. You can use the Flash Knife to pour out blood. When pouring blood, it passes through the blood. It also allows blood to pass through it. When pouring blood, it passes through the blood. Passes blood. It is like this. So check the mark. It's on the left. Something like this. Now, make a pocket in this direction. Then, use the water boat to enter from here. from here, And yes, you can cut in any direction. Rotate and start from here yeah? Shall I throw it in again? Yes, I'll throw it in when I see the layer of muscle. Let's look in this direction. and, ok nail out inject ok stop Staff, yes yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Okay, formula So Okay, from here, is this a layer of fat? Let's measure the depth here, here. Yes, it's very close. Then the direction is fine. And I should now focus on the mucosal side. I should now reduce the depth since it is closer to the edge of the pocket. Then look up at the mucosal side. This is the outside of the kidney, this is the outside of the kidney. Then I should reduce the depth now. And, I Pull, pull, and take a look. This is the opening. Okay, let's cut it out here. Now, what about the other side? I might start cutting from here. Next I made the bridge. Let's take a look at the width of the pocket. This side is already wide. The same goes for the other side. This side is wide. Let's make some adjustments here. Ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo Yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, that's right, that's right, that's right, that's right, that's right, that's right, that's right, that's right, that's right, that's right, that's it. Do you have a clip and line? Now cut the Mucoser. Give the last injection before cutting Mucoser. Please inject. A pocket was made and the final injection was given. It is like this. Since you have Mucoser left over, give an additional injection through Mucoser. OK, let's inject. inject Let's cut it.Let's cut the Minkoser. Minkoser makes a cut from the Auror side to the Ender side. The length of the Ender cut is 4. This way you can avoid perfection by lowering it instead of raising it. Yes, it's connected to the other side. This is a slightly deeper cut. Can I tell you what's behind? Switch on Maybe it's not necessary. Now let's have a drink. The markings are slightly on the outside, so please wait a moment here. Marking is deviity If this was a real marking, I needed to go out, so I decided to go out. You can use levitation, levitation. Do you want to open it? Do you want to open it? Yes, please stop. Please open it again and close it. Make sure to close tightly and avoid pulling on the muscle layers. I think this is okay. This is fine. in this way, Try not to pull your muscles. This way, avoid pulling your muscles. Now, I'd like a knife, please. Shall we use dry cuts? Shall we use dry cuts in water? The water is empty, but Gas came out instead of water. Isn't there a sail line? Thank you for your viewing I changed the swift quag. Swift Quag works, but it creates a lot of bubbles. But I can control the length of the current. Bubbles are coming in and it's getting dirty. I'm running out of bubbles, but I'm getting air instead of water, so I changed my strategy. I changed the swift quag. Now let me show you how to open the pocket. Remove the mucosal stamp from the inside of the pocket and cut out the mucosal stamp. It's the same repetition. Now cut out the other side. Remove the mucosal stamp from the inside of the pocket and cut out the mucosal stamp from the other side. Remove the mucosal stamp from the inside of the pocket and cut out the mucosal stamp from the other side. Remove the mucosal stamp from the inside of the pocket and cut out the mucosal stamp from the other side. The pocket is a little too deep, so I'll cut it out here. Take the mucosal stamp, take the mucosal stamp from the other side, take the mucosal stamp from the other side, and cut out the mucosal stamp from the other side. This will be the edge, so cut it from here to here. Yes, and the last part remained on this side. Maybe it was cut out. Here, this is the last fiber. Yes, that's it. Then remove the special along with the stick. Oh, excuse me, could you show me the camera? Can you show me? Could you show it to me? Can you show me a clip, like in Phishing? I have a clip so I can show you the exact direction of the aura. This is the direction of the aura. Yes, that's it. thank you very much.

Dr. Yamamoto

surgical procedure

pockets

Small Cal Reaver

buoyancy

endoscope

mucosa

cutting technique

final result