Abstract
The electrosurgical unit (ESU) is an essential tool in endoscopic treatment. It creates the necessary electronic current to create thermal energy in the target tissue delivered by endoscopic devices (e.g. snare, probes, and forceps). Advancement of ESUs has helped ESD procedure tremendously making it safer and more efficient. ESUs have their various modes specific to the company. In order to understand the theoretical basics and to benefit by help selecting the appropriate mode for each step of ESD, basic knowledge of electric current and energy are explained in the context of ESD procedure, and most used ESU settings are discussed on each specific modes. The optimal application of electrosurgical waveforms in ESD is as much an art as it is science.
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Video 9.1
Controlled mucosal incision using Dual Knife with ENDO CUT (MOV 5,500 kb)
Video 9.2
SM dissection with FORCED COAG (tap tap foot switch control with controlled movement) (MOV 3,003 kb)
Video 9.3
SM dissection in the area of rich neoplastic vessels. Needle knife is moved slower with FORCED COAG to coagulate vessels prior to cutting (compare with 9.2) (MOV 2,554 kb)
Video 9.4
Post-resection coagulation of vessels using SOFT COAG with Coagrasper. Tenting the tissue prior to application is important to limit deep thermal injury. Careful touch-and-coag technique is shown here (shorter application under direct visualization is necessary) (MOV 5,929 kb)
Video 9.5
Video 9.5 SPRAY COAG during POEM for submucosal tunneling is effective (non-contact dissection) (MOV 18,536 kb)
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Fukami, N., Bults, A. (2015). Electrocautery for ESD. In: Fukami, N. (eds) Endoscopic Submucosal Dissection. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2041-9_9
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DOI: https://doi.org/10.1007/978-1-4939-2041-9_9
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-2040-2
Online ISBN: 978-1-4939-2041-9
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