ASGE-JGES Endoscopic Submucosal Dissection ESD (On-demand) | October 2025-LAB - Advanced ESD Techniques

Video Transcription

Video Summary

Dr. Kitamura from Jichi Medical University demonstrated the pocket creation method for endoscopic submucosal dissection (ESD) using the Fujifilm flash knife with a ball tip and water injection capability. The method involves making a minimal 15mm incision away from the marking to create a pocket for submucosal dissection without lifting the entire mucosal layer. A small paper tape attachment cap aids in entering the pocket. Dr. Kitamura emphasized careful shallow dissection to avoid muscle injury, constant visualization of muscle and submucosal layers, and the importance of controlling the incision size to maintain traction. The procedure utilized specific tools—mainly needle-type knives combined with the ST hood with instrument guide—and techniques like adjusting knife orientation parallel to muscle and sometimes underwater dissection. Gas aspiration was highlighted to prevent perforation risk. Despite technical issues stopping the live demonstration, Dr. Kitamura shared insights on safe, efficient ESD using the pocket creation method to improve stability and visibility during dissection.

Keywords

pocket creation method

endoscopic submucosal dissection

Fujifilm flash knife

ball tip water injection

submucosal dissection

needle-type knives