ASGE-JGES Endoscopic Submucosal Dissection ESD (On-demand) | October 2025-Electrosurgery Principles in ESD

Video Transcription

Video Summary

The speaker discusses electrosurgery in endoscopic submucosal dissection (ESD), emphasizing understanding and adjusting electrosurgical generator settings to optimize tissue effect. They explain various generator modes—unmodulated (soft coag, auto cut) and modulated (forced coag, dry cut, spray coag)—and their applications in marking, incision, dissection, and hemostasis. Key points include tailoring settings to the tissue type, knife used, and procedural needs, highlighting that cutting requires high current density while coagulation benefits from low current density and larger surface area, exemplified by the use of coag graspers for vessel control. The lecture demystifies Endocut settings, detailing parameters like effect (coagulation), duration (cut pulse length), and interval (coagulation phase length), advising experimentation to find optimal settings. Ultimately, effective use of electrosurgery involves adjusting generator settings based on tissue response, device choice, and technique rather than relying on fixed settings, with continual learning and adaptation encouraged.

Keywords

electrosurgery

endoscopic submucosal dissection

generator settings

coagulation

cutting modes

Endocut parameters