Endoscopic Submucosal Dissection (ESD) (On-Demandl) | December 2024-Fukami

Fukami_ESD Devices

Pdf Summary

The document details tools and methodologies for Endoscopic Submucosal Dissection (ESD), a procedure used primarily for the removal of superficial gastrointestinal lesions. Authored by Dr. Norio Fukami from Mayo Clinic Arizona, it outlines the technical steps and equipment involved in ESD.<br /><br />Firstly, the process begins with evaluating the lesion and planning the ESD procedure, including considering the specific ESD method to be used. An assortment of tools is necessary for successful ESD, including endoscopes, marking tools, injection needles, various knives, traction devices, and hemostasis and closure tools. Each tool has specific functions and variations, such as endoscopes with different lengths and channel sizes, various types of injection fluids, and specialized knives and scissors for precise cutting and coagulation.<br /><br />Advanced techniques such as traction-assisted ESD can reduce procedure time and adverse events by improving access to the submucosal layer. Traction methods include external devices like the S-O clip or internal techniques such as double-channel scopes, which facilitate easier tissue manipulation during the procedure.<br /><br />For hemostasis, the use of epinephrine, electrosurgical currents, and hemostatic agents ensure bleeding control during ESD. Devices to approximate tissue include various clips and suturing systems, tailored for different application requirements and sizes.<br /><br />The document also mentions methods to pin and orient excised specimens for pathological assessment, ensuring accurate orientation and assessment of margins. This includes using pins and corkboards for specimen management.<br /><br />The summary concludes with acknowledgments towards Mayo Clinic's Phoenix and Scottsdale locations and invites a Q&A session to discuss further on ESD.

Keywords

Endoscopic Submucosal Dissection

ESD tools

gastrointestinal lesions

Dr. Norio Fukami

Mayo Clinic Arizona

traction-assisted ESD

hemostasis methods

specimen management

electrosurgical currents

pathological assessment