Well, certainly, we know that argon plasma coagulation around the margins of a polyp, especially over 15 millimeters, does tend to reduce the risk of polyp recurrence. So a lesion that's over 15 millimeters, even if you take it off in block, you should still APC around the margins. And this applies for things 15 millimeters or larger in size. It was a small randomized trial, but it was a good one. And so the risk of recurrence at that point was 10%. With no APC, it was around 64%. Subsequently, after this publication, there's been multiple other studies that have also supported this, including getting the edges with soft-snare tip coagulation as well. And so what are some of the technical details? I get a lot of questions about this. The technical details for this APC are going to be 30 to 45 watts argon and about a liter. And you want to do it in short bursts. You don't want to sit there and paint like you would for something like GAFE or radiation peroctitis. It's really just a couple of key short blasts, get it a little bit brown around the edge and keep moving. And then you really want to try to avoid getting that muscularis. And that just helps to avoid transmural thermal injury and potential perforation. Again, remember, APC isn't meant to go very deep. It only goes about one to three millimeters in depth. So if it looks like you have more tissue that's still there, you're probably going to need to use a different technique like biopsy or avulsion. So here we can see a lesion. We've taken this off here. And there's a little tiny nub there. And application of APC, again, APC is a non-contact therapy, meaning you don't have to touch and you shouldn't touch the tissue that you're trying to get with the probe. You should probably be around a millimeter to two millimeters away from it. And that arc is what will carry that electro current and allow your chart feature. Remember, it does put in argon gas. So you're going to want to maintain visualization of your lumen and suction appropriately to suck out that gas that you put in to potentially avoid barotrauma. So the take-home messages for APC use, large lesions, make sure that you get around the margins of your polypectomy site. It reduces the rate of recurrence. Certainly, in piecemeal polypectomy, either touching up those margins, as I said, or little sort of tiny islands within that area. Know your settings. If you're uncomfortable or unfamiliar with their settings, there's always representatives who are happy to help. There's always others at your institution who would be happy to help. I would encourage you to practice with it before you go in. Certainly, the opportunity is there to even use different food products like, you know, bologna or other things and almost do your own ex vivo lab at some point to really become familiar with your settings and how to use it. And then avoiding that muscularis layer.

argon plasma coagulation

polyp recurrence

APC efficacy

technical details for APC

avoiding thermal injury