Loading video...

Video Failed to Load

Go Home

Endoscopic Submucosal Dissection (ESD) for a 4 cm Sigmoid Polyp with High-Grade Dysplasia

10,440 views • 1 year ago •via X (Twitter)

8 Comments

ali mohmd's profile picture
ali mohmd1 year ago

Is this a stalk? Who not using an endoloop followed by hot snaring??

Flaubert Sena de Medeiros's profile picture
Flaubert Sena de Medeiros1 year ago

For a polyp with a large cephalic portion and a narrow sigmoid, do not rely on opening the loop and the snare. However, this is just one tactic.

pedro bastos's profile picture
pedro bastos1 year ago

cautery settings?

Marcio Paraboli's profile picture
Marcio Paraboli1 year ago

@AdrianaPhalange Congrats Great Job👏👏👏

Syed Saad Ahmed's profile picture
Syed Saad Ahmed1 year ago

Omg

د يوسف بن طواله's profile picture
د يوسف بن طواله1 year ago

Hi . can you please send me a direct message . Thanks

Romulo Freire's profile picture
Romulo Freire1 year ago

O que você usou para injeção?

Flaubert Sena de Medeiros's profile picture
Flaubert Sena de Medeiros1 year ago

Salina com azul

Related Videos

Got a high grade for 90 mins going to rump her sillly
0:23

Sensitive content

Got a high grade for 90 mins going to rump her sillly

Danny Boy

53,671 views • 5 months ago

*Video and images shown with full, written informed consent from the patient. Our first ESD of 2024, performed last week, using our saline-immersion technique (SITE)-facilitated, tri-tunnel variation of the pocket-creation method (PCM). The lesion was a 12 x 9cm laterally spreading tumour involving the ileocaecal valve, caecum and ascending colon*. Dissection speed: 28.3 mm^2/min. SITE, which we first described in 2016, enhances patient comfort (avoiding the need for deep sedation), obviates the need for any traction (through buoyancy), enhances optical clarity (through elimination of dissection-related smoke, fat micelles, debris and through intrinsic magnification), and enhances visualisation of vessels and bleeding points. The use of saline (not water) is critical for conductivity. High-effect, forced coagulation enables very effective knife-alone management of vessels and any bleeding, and this, coupled with the use of self-assembling protein matrix gel (Purastat), obviates the need for the use of coagulation forceps. All these factors contribute to increased efficiency, effectiveness and patient comfort. Histopathology of the specimen confirmed complete (R0) resection and showed that the lesion consisted of a low grade dysplastic lesion without any evidence of invasive malignancy, confirming cure. ESD is an endoscopic microsurgical technique which affords an en bloc, organ-preserving, minimally invasive cure for such lesions, which unlike piecemeal resection, offers R0 with virtually no risk of recurrence; this latter point eliminates the need for tight surveillance and related patient inconvenience/risk, also reducing cost and environmental impact. Onwards and upwards for the betterment of minimally invasive care for all our patients!

Edward J. Despott

20,356 views • 2 years ago