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

Video Transcription

Video Summary

Dr. Yutaka Tomizawa from the University of Washington demonstrated the new LV hybrid knife for endoscopic submucosal dissection (ESD). The knife features a 2.0 mm tip enabling effective cutting and injection via a water jet through a needle, with the advantage of a smaller catheter diameter that preserves suction. The device allows the assistant to remain hands-free due to the knife’s ability to stay open or closed independently. Dr. Tomizawa explained using different needle sizes based on tissue thickness—2.5 mm for stomach, 1.5 mm for colon and esophagus. Compared to older models, this knife has a thinner fixed-length needle, enhancing cutting precision but slightly reducing coagulation. Injection technique involves creating a small mucosal incision before injecting to avoid submucosal blistering, with continuous inject-and-cut capability improving efficiency. Although only saline solutions can be injected, the knife handles thick mucosa well. The team plans new models (T-type) with hooking mechanisms. Overall, it's user-friendly, particularly for those experienced with dual knives.

Keywords

LV hybrid knife

endoscopic submucosal dissection

water jet injection

needle size variation

inject-and-cut technique