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Endoscopic Submucosal Dissection (ESD) (In-person ...
Q&A 3
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a lot of energy, a lot more energy than in air. So I know that they're working on it and they're working on modifications to allow for better underwater electrical surgical applications, but there's no clear resources at this time. Okay, thank you very much. So I think the basic principle, I think Dr. Yahagi and Dr. Kato was always saying that if you have a very, like a needle-type VST knife with a very high current density, you don't need to change the setting. Is that correct? And then if you are using the coagulasper, which has a very low current density, I think the electricity conduction is very poor. So in that case, you have to sometimes like extend, like put some air or CO2 to be able to coagulate blood vessels. I think that's the problem. Yeah, because if you, especially if you're using saline, so saline is so conductive. If you use like a soft, if you're using coagulaspers and you're putting a lot of energy, it actually heats the saline quite a bit. And I've heard anecdotes of thermal injury. Yeah, thermal injury to the mucosal surface because of the distribution of heat. So you have to be really conscious of how much energy you're dumping in. The thing with coagulaspers, it's really important. If you don't see tissue effect and you're stepping on the pedal, that energy is going somewhere, right? So don't stay on the pedal. Stop and figure out where's my energy going and then try and reorient it because it could be that you have too much of the coagulasper on other tissue or if you're in water, it's being dissipated through the saline. So allow for one to two seconds. If you don't see any tissue effect, then stop because otherwise you could potentially be delivering and monopodal energy somewhere deep into the body where you're not anticipating. Okay, yeah, that's a great point. Any questions from audience? Hey, no question is a good thing. Oh yes, please. I have a question. Are these available as recordings for the studio? Are the lectures available as a video recording to listen to in the future? I have to ask. Yeah, we'll look into it and we'll get back to you. I think the live, so we actually did the live case demonstration for virtual audiences. So I'll see if we can provide it. It's very useful and informative video. All faculty showed their skill techniques in ESD. And then I'm hoping to get you some like information from this course. Any other questions? I have a question. Yeah. Where is Dr. Taranto? Sorry, yeah. He's probably in Florida right now. He has some family issues. So he had to leave early today, right? Any questions? What's the post procedure care for your patients? Post procedure care. Okay, let me, I think it depends on the location of the lesion. So I prefer putting the patients on clear liquid followed by full liquid and a few days of soft diet for a few days for the gastric ESD. But the colon, we usually do just soft diet for a few days. Any other thoughts from faculty? Yeah. In Japan, we used to admit patient about five day or seven days because of national insurance system is very cheap. And I decided I moved to New York. And New York has so many lawyers. So even though, I know, he don't let the patient go home on the same day. But I decide to let them stay one night at least, yes. Thank you. Any other questions? But lastly, I would like to thank all the faculty for dedicating your weekend for this course. It's so successful. I'm so appreciative for your effort. And also, especially for the Japanese faculty and Dr. El-Khoury from Egypt for just flying out of your country to teach at this course. I really appreciate your time. Thank you very much. Thank you. So lastly, before you go, I think ASG has a special video. So this is endoscopy tech week. So we wanted to show you this 10 minutes video before you leave this institution. Thank you very much. Enjoy the video. Greetings from IGIE, where we are celebrating our technicians, our hard-working heroes who bring success to endoscopy day in and day out. Hats off to the backbone of endoscopy. Hi, I'm Laricia, I'm an endotech here at Baylor St. Luke's, and I just want to say happy endotech week, guys! Happy endotech week! Hey, we're the endoscopy crew from the University of Mississippi Medical Center. We want to wish our endoscopy techs a happy endotech week! My name is Carmen, Dwayne, Christine, and we're part of Scarborough Health Network, University of Toronto. Happy endoscopy tech week! Hi, I'm Maxine, I've been with UVA Health Endoscopy for the last 18 years. Happy tech week! Hey, my name is Carlos, I work here at the Tri-Municipal Endoscopy Center here in Tri-Municipal Mississippi. I just wanted to say happy endotech week, so great job! Yay! We are techie, techie, uncle! I love my job! 中山医院内静中心 Happy Anglo Tech Week! 我们在华西的附属中山医院内静中心 Happy Anglo Tech Week! Hi, my name is Raquel. I work at Baca Cancer Center. Happy Anglo Tech Week! Happy Anglo Tech Week! Happy Anglo Tech Week from Baca Cancer Center! Yeah, I'm with our fantastic Anglo Techs. Hi, I'm Jay. Hi, I'm Micah. I'm the nurse. Hi, Amber. Michael. Joel. And on behalf of all of us, Happy Anglo Tech Week! I'm Cecily. I'm Cathy. I'm Alexandra. I'm Amy. Happy Anglo Tech Week! Happy Anglo Tech Week! My name is Amber. My name is Jamie. My name is John. My name is Elizabeth. My name is Tammy. My name is Derek. My name is Morgan. My name is Isamar. My name is Sandra. We are Dallas Methodist GI! Hi, my name is Lola. I work at Kingston Health Science Centre in the endoscopy unit at Hotel Do. I love the experience here, the patients, and all the equipment changes and everything is fast and up to date. Hi, I'm Larry. Hi, I'm Tanya. Hi, Louis. Hi, I'm Mark. Hi, I'm Tanya. I'm Pearl. Hi, I'm Jessica. Hi, I'm Lynn. Hi, I'm Magida. I'm Roy. Hi, I'm Yadi. I'm Chris. I'm Lauren. Hi, I'm Kim. Hi, I'm Jonas. Hi, I'm Ashley. Hi, I'm Dion. Hi, I'm Danny. Hi, I'm Micah. Hi, I'm Elisa. My name is Tony. Hi, I'm Judy. Hi, I'm Tina. Hi, I'm Vanessa. Hi, I'm Richard. Hi, I'm Claudia. I'm one of the endotechs here at MD Anderson Cancer Centre. Being a good tech is somebody who cares, being one step ahead of the doctor, always being ready to make sure that you have the equipment you need before the physician even asks. Hi, I'm the endotech queen from Houston, Texas. And we're endoscopy techs at the NSHUTS campus at University of Colorado. And it's happy endotech week. Hi, my name is Rudy. I work at UK Chandler in Kentucky. I've been teching for 10 years, two years traveling. Uh, the most important thing about teching is knowing your estimates and communication with your doctor. Hi, my name is Mary Shine and I currently work at DT Stockdale's Free Medical Center as an endoscopic tech nurse. I'm passionate about patient care and dedicated to maintaining high standards in the work I do. Hello, I'm Lusoya from EventHealth Orlando, CID. My name is Latoya Montgomery. Hi, my name is Raynalise Torres. Hi, my name is Bevin and I work for the CIE department. Hi, my name is Gene Hive. Hello, my name is Omar. Hi, my name is Matthew. What I like about the department I work in, we're family oriented. You feel the love, you feel the kindness. I'm Shondalyn Branch and I'm Donyell Stanley. And we're from University Hospitals of Cleveland. And when we make it to the SECUM, we do the SECUM dance. As an endoscopy assistant, we make the room a better place. Happy endoscopy week. Happy endoscopy tech week. Hello, my name is Omar. I'm from Atlanta, Georgia. And this week is tech week. Teching is, everything is new. But at the end of the day, we all learn at the end of the day. It's a new experience. Happy tech week. I love what I do because I appreciate the level of camaraderie that goes into being a part of the ENDO team. I am Emory Proud. Hello, my name is Joshua. I'm a 10-year GI tech at Emory University Hospital. I enjoy doing this because I enjoy helping patients and doing advanced ENDO. Hi, my name is Tashina from NYU Langone, Long Island. Wishing you a happy ENDO tech week. My name is Elaine. I'm one of the nurses from NYU Langone, Long Island. I just want to say to everybody, happy GI tech week. Hi, my name is Suli Gisson. I'm a GI tech at NYU Long Island. I hope you all enjoy to be a tech as much as I do. Hi, my name is Vanessa Middleton. And I'm one of the ENDO nurses at NYU Langone, Long Island. Happy GI techs week. And thank you to all of the technicians that help make the cases happen. Hello, hello. My name is Kelvin Edwards, lead GI tech from NYU Long Island. I'm just reaching out to wish all the techs happy GI week. I'm going to introduce you our co-workers, our assistants in endoscopy. Hi, my name is Vern. I've been a nurse here in endoscopy for the last 13 years. Hi, my name is Nael. And I'm an interventional endoscopy technician at New York Presbyterian Columbia. My favorite thing about my job is that I'm always learning something new every day. And I like to see the different innovations that we can use for our patients. Hi, I'm Ray. I'm one of the nurses in New York Presbyterian Endoscopy, Columbia Irving University campus. Hello, my name is Polly. I'm one of the interventional techs at New York Presbyterian Hospital of Columbia. My favorite thing about my job is that I get to train all the newcomers. Happy Endoscopy Tech Week! Bye! Hi, I'm Kayla. And I'm Sydney. And we just want to say happy Tech Week from Mayo Clinic. Happy Endoscopy Tech Week! From UF Health Shands in Gainesville, Florida. Hi. Hi, my name is Ribiana. You are from Brazil. Happy Endoscopy Tech Week! Hi, everyone. I'm Julio from the American Polybry, Wisconsin. I'm one of the interventional endoscopy faculty over here. As you all know, nothing is possible in interventional work or anyone without the excellent support from my A-team. Happy Endoscopy Tech Week! Hello. I'm Dr. Asadul Chakmedian, head of the endoscopy department here in Montevideo, Uruguay, with all the team nurses here. So happy Endoscopy Tech Week! Hi, I'm Suha. I'm an endoscopy technician at the Dallas Polybry Specialty Hospital in Napa, India. I'm proud to be an endoscopy technician here at the Dallas hospital. With every day I need to be part of a team, where the patient must receive the same place every Thursday. As endoscopy technician week is coming, so I have to give a big cheer to all the techs out there. It's a great reminder of our dedication and teamwork for a successful procedure. Next year, we will take patient care in one's home at a time. Happy Endoscopy Tech Week! And we wanted to wish all the techs a very happy Endoscopy Tech Week. We love and appreciate all of the hard work you do. Let's keep it up and keep going! Yeah, let's say thank you to our techs when we go back to the hospital tomorrow. Have a great weekend and have a safe ride. Thank you. Bye-bye.
Video Summary
The video transcript covers discussions from a medical conference on advancements in underwater electrical surgical applications, particularly addressing energy management and safety during procedures involving coagulaspers. Key points include avoiding excess energy application to mitigate thermal injury, especially when using saline, due to its conductivity. Techniques to improve energy distribution and patient safety are highlighted. A segment addresses audience questions about post-procedure care, detailing dietary recommendations after procedures like gastric and colon ESD. It also touches on differences in patient care based on geographic regions, highlighting varying healthcare practices. The event concludes with expressions of gratitude to the faculty and international attendees for their participation and teaching contributions. Finally, there's a celebration of Endoscopy Tech Week, featuring messages of appreciation from various global healthcare teams acknowledging the essential role of endoscopy technicians in their successful operations.
Keywords
underwater surgical applications
energy management
coagulaspers
patient safety
Endoscopy Tech Week
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