ASGE JGES Primer ESD (On-Demand) | September 2022-Identifying and Managing Complications

Video Transcription

Video Summary

The video transcript centers around the topic of endoscopic submucosal dissection (ESD) and the complications that may arise during the procedure. The speaker, Dr. Sergei Zivotsky, discusses the challenges of dealing with complications during ESD, such as bleeding and perforation. He emphasizes the need for proper training and skill development in managing complications, as they differ from those encountered in traditional surgeries. Bleeding is the most common immediate complication during ESD, and factors such as polyp size and histology contribute to its occurrence. Dr. Zivotsky recommends using electric current controlled by processors to prevent bleeding and highlights the limitations of clips in stopping bleeding during the procedure. He also discusses the use of hemispray as a temporary control for major bleeding. Regarding perforation, Dr. Zivotsky explains the difference between perforation during ESD compared to EMR (endoscopic mucosal resection) and the importance of full-thickness closure with suturing devices for small perforations. He emphasizes that suturing devices offer surgical-quality closure for full-thickness perforations. Dr. Zivotsky concludes by discussing the prevention of delayed complications such as bleeding, perforation, and stricture formation post-ESD. He recommends closure of large mucosal defects with suturing devices to prevent these complications.

Asset Subtitle

Sergey V. Kantsevoy, MD, PhD

Keywords

endoscopic submucosal dissection

complications

bleeding

perforation

training

electric current

hemispray

suturing devices