ASGE JGES Advanced ESD | September 2022-Toyonaga_Pre_Coagulation on Vessels with low dose energy with knife

Toyonaga_Pre_Coagulation on Vessels with low dose energy with knife

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This presentation discusses the technique of pre-coagulation on vessels with low dose energy using a knife during endoscopic procedures. The author, Dr. Takashi Toyonaga, has financial relationships with Olympus and Fujifilm. Bleeding during mucosal incision is addressed through the use of forceps and soft coagulation. The architecture of the gastrointestinal wall and the appropriate level for dissection are examined. Small vessels are treated with a knife and forced coagulation, while large vessels are pre-coagulated with forceps and soft coagulation. The technique of "endoscopic vessel sealing" is introduced as a novel method for precoagulating blood vessels during endoscopic submucosal dissection. Different coagulation techniques such as soft coagulation, forced coagulation, Endo-Cut, Dry Cut, Swift Coag, and Spray Coag are discussed, with adjustments in watt settings. The study found that forced coagulation with low high-frequency power setting significantly reduced bleeding in large vessels compared to soft coagulation. Impedance, voltage control, and measuring cycles are also discussed. The technical summary of pre-coagulation on vessels with low dose energy with a knife includes the use of forced coagulation at low watt settings and vessel exposure using whiten forced coagulation.

Keywords

pre-coagulation

vessels

low dose energy

knife

endoscopic procedures

bleeding

forceps

soft coagulation

gastrointestinal wall

coagulation techniques