ASGE JGES Primer ESD | September 2022-Traction During ESD

Video Transcription

Video Summary

In this video, Dr. Inoue discusses the traction method during ESD procedures. He explains that traction is a simple technique used to keep tissue traction during surgery. There are several techniques for traction, including external traction and internal traction using subdevices or magnets. Dr. Inoue also discusses the clip and line technique, which is commonly used in the upper GI tract. He explains that this technique involves fixing a thread to one side of a clip arm and placing the clip at the proximal end of the mobilized tissue to create submucosal tension. Dr. Inoue also discusses other commercially available devices for traction, such as the SO clip and the end-rifter. He presents the results of RCTs that show that traction techniques can reduce procedure time and perforation rates, making the procedure safer and faster. He also introduces the multi-point traction technique, which involves using multiple clips to create tension and facilitate dissection. Dr. Inoue demonstrates the use of traction techniques in various procedures, including submucosal dissection and full thickness resections. Finally, he briefly discusses the use of traction techniques beyond ESD, such as in EMD and ESSD procedures.

Asset Subtitle

Haruhiro Inoue, MD, FASGE, PhD

Keywords

traction method

ESD procedures

tissue traction

external traction

clip and line technique

upper GI tract

submucosal tension