ASGE-JGES Endoscopic Submucosal Dissection ESD (Live and Virtual) | October 2025-LAB - Conventional ESD Techniques

Video Transcription

Video Summary

This video presents a detailed instructional session on performing conventional Endoscopic Submucosal Dissection (ESD), focusing on practical techniques and tool usage, specifically the Boston Scientific Kuro knife. The Kuro knife features a locking mechanism and allows direct injection through the needle tip, enhancing precision in submucosal lifting and marking. The presenter emphasizes injection methods, typically using Blue-Eye or Endocrine solutions, and discusses best practices for maintaining scope stability during the procedure. The session covers strategic incision techniques, such as starting at the gravity side to optimize dissection and using low-force coagulation modes to manage vessels and bleeding effectively. Retroflexion techniques and safe distance maintenance from the muscle layer are demonstrated to preserve specimen integrity. Post-ESD care in Japan versus the US is compared, highlighting closure practices, hospitalization decisions, and medication protocols. The discussion also touches on reimbursement and adoption trends for closure devices, reflecting evolving clinical and economic considerations in ESD.

Keywords

Endoscopic Submucosal Dissection

Boston Scientific Kuro knife

Injection techniques

Scope stability

Incision strategies

Post-ESD care