ASGE JGES Advanced ESD (On-Demand) | September 2022 OLESDSEPT22ADV-Lab Hands on Virtual Demonstration Part 3

Video Transcription

Video Summary

In this video, the presenter demonstrates the water pressure method for endoscopic submucosal dissection (ESD) using a porcine stomach model. The water pressure method utilizes the active pressure of normal saline to open the sub-mucosal space, making the ESD procedure easier and safer. The presenter emphasizes the importance of washing the lumen completely before starting the procedure and placing the marking dot. The Dual Knife-J is used for the procedure, which allows for marking, mucosal incision, sub-mucosal dissection, and injection of additional fluid cushion. The video also covers the use of hyaluronic acid solution for fibrosis and the importance of staying on the surface with the knife tip. The presenter demonstrates the technique by making a circumferential mucosal incision and then proceeding with sub-mucosal dissection under the water-filled stomach. Some tips are shared, such as using cutting current mode to prevent air bubbles and the importance of checking for vascular networks in the submucosal layer. Overall, the presenter highlights the advantages and techniques of the water pressure method for ESD.

Keywords

water pressure method

endoscopic submucosal dissection

ESD

porcine stomach model

normal saline

sub-mucosal space

washing the lumen