ASGE JGES Advanced ESD | September 2022-Case Study Discussion 2

Video Transcription

Video Summary

In this video, a doctor discusses a case involving a large lesion in the hepatic flexure. The doctor explains that they evaluated the gravity, lesion stability, and scope access before performing an endoscopic submucosal dissection (ESD). They then discuss two techniques for facilitating ESD in difficult cases: traction and pocket creation. The doctor chooses to start with the pocket creation method but encounters difficulty accessing the right side of the lesion. To overcome this, the doctor changes the patient's body position and uses traction with a rubber band to create better access. They demonstrate how traction helps in dissecting the lesion without damaging the muscle layer. After completing the dissection, the doctor discusses options for retrieving the large resected specimen, including using suction or alligator forceps. They also mention the availability of an 80mm retrieval net in the United States. The video concludes with the successful removal of the lesion and discussion of post-resection strategies.

Asset Subtitle

Hiroyuki Aihara, MD, PhD, FASGE, FJGES

Keywords

hepatic flexure

endoscopic submucosal dissection

traction

retrieving specimen

post-resection strategies