Video Tip: How to Avoid Incomplete Endoscopic Resection-How to Avoid Incomplete Endoscopic Resection

Video Transcription

So how can we avoid incomplete endoscopic resection? And so there's several answers. First, you just need to visualize the entire lesion.  So making sure that you really clearly define how big the lesion is, what it looks like, use enhanced imaging techniques, white light, narrowband imaging, all certainly help.  Other things from a mechanical point of view that you can do is really manage your insufflation.  Make sure that you insufflate enough so that you gain space, so that you can see where that lesion ends and begins, and if it goes over a fold.  If it's challenging or you're not sure, always be able to reposition that patient carefully. Or you can use an assistive device, such as a cap, and I have a clear cap there.  It's very similar to your banding caps. It comes separately, so you don't have to open up a banding kit to be able to use it.  But clear caps can be especially helpful to just push down that fold that might be always in your way, as any of us who have done these a lot tend to find the most challenging  situations when a fold pops up in front of you. So it helps to bat it down so that you can see the entire lesion clearly through it.  And then certainly, you do have the opportunity to retroflex. And so in this video here that will play in a second, you can see we're doing colonoscopy here.  The colonoscope is retroflexed, and this polyp, which you see is here behind a fold, you can also see the edges of that clear cap around it to help us visualize the entire lesion.  And using electrocautery, or snare cautery, we've taken this lesion in block, and you can see the resulting area there.

Video Summary

The video highlights methods to avoid incomplete endoscopic resection. It suggests visualizing the entire lesion using enhanced imaging techniques like white light and narrowband imaging. Managing insufflation to gain space and accurately determine the boundaries of the lesion is also important. Repositioning the patient or utilizing an assistive device like a clear cap can help overcome challenging situations where folds obstruct the view. Retroflexion can be employed to visualize polyps behind folds. The video showcases a colonoscopy where electrocautery or snare cautery is used to remove a polyp successfully. No credits were mentioned in the transcript.

Keywords

endoscopic resection

enhanced imaging techniques

insufflation management

clear cap device

polyp visualization