GEL IMMERSION ENDOSCOPY FOR GASTROINTESTINAL BLEEDING (WITH VIDEOS)

Abstract

During endoscopy for gastrointestinal bleeding, it is difficult to secure the visual field. When it is impossible to secure the visual field with gas insufflation and suction, we often use the water immersion method. However, the infused water rapidly mixes with blood, and the improvement of the visual field is limited. Gel immersion endoscopy, which is a new method using a transparent gel instead of water, enables the creation of a working space occupied by the gel, because the gel does not mix with blood immediately and pushes away the blood and clots. In this working space, it is possible to achieve endoscopic hemostasis under direct observation. The dedicated gel for this method enables the use of mono-polar devices in the gel. This method is useful in various situations such as colonoscopy with poor preparation and endoscopy with low inner pressure. This method is expected to become widely adopted as a third method for securing the visual field.