Safe and economical use of hemostatic forceps for dissecting fibrosis or vessels during endoscopic submucosal dissection

摘要

Endoscopic submucosal dissection (ESD)is a well-established therapeutic strategyfor resecting early gastrointestinal neoplasms[1–3].However, operators sometimesencounter difficult situations duringESD, resulting in longer proceduretimes and an increasing complicationrate. The more complicated situationsinvolve encountering the muscularis propria(MP) and submucosal fibrosis,managing large or rich vessels, and resectingthe endpoint. In these situations,a device such as a scissors type of knife[4] is sometimes introduced. However,use of a scissors type device in additionto a needle knife becomes uneconomical.Here we describe an effective incisionusing HF for overcoming the aforementioneddifficulties in esophagealESD (?Video 1).