ASGE JGES Primer ESD (On-Demand) | September 2022-Yuto Shimamura

Yuto Shimamura_ESD Basic Techniques

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This document provides an overview of basic techniques for endoscopic submucosal dissection (ESD). ESD is a minimally invasive procedure used to remove lesions from the digestive system. The document highlights the importance of preparation and discusses various techniques and tools used during ESD.<br /><br />Preparation for ESD involves using distal attachments, such as a super soft hood, to adjust to narrow spaces and maintain a clear field of view. Electrocautery generator settings are also discussed.<br /><br />The document outlines the different phases of ESD, including marking the lesion, injection, mucosal incision, trimming, and submucosal dissection. Various tools and techniques, such as different types of electrosurgical knives, are described for each phase.<br /><br />The importance of proper injection techniques, including the choice of injection needle and solution, is emphasized. The document provides tips on how to achieve precise injections and maintain submucosal elevation.<br /><br />Tips and strategies for achieving smooth and efficient ESD are discussed, including the use of traction techniques and the importance of slow and steady dissection. Different traction methods, such as the clip with line method and multipoint traction method, are explained.<br /><br />The document also provides tips for beginners in ESD, including what to avoid and essential practices during the procedure. Strategies for managing challenges, such as fibrosis, bleeding, and fat, are outlined.<br /><br />Overall, this document offers a comprehensive overview of ESD techniques and provides helpful tips and strategies for performing the procedure effectively and safely.

Keywords

endoscopic submucosal dissection

minimally invasive procedure

digestive system

preparation

distal attachments

super soft hood

electrocautery generator settings

phases of ESD

injection techniques

traction techniques