GASTRIC ESD USING AN ENDOSCOPE WITH A MULTI-BENDING FUNCTION (WITH VIDEOS)

Abstract

ESD has become the standard treatment for early gastric cancer, and this technique has matured significantly over the years. However, perforation remains a major adverse event that can result in fatal outcomes. The multi-bending endoscope used for ESD allows close proximity to the dissection area by adjusting the up-and-down angles of the second bending section and contributes to improved safety and speed of submucosal dissection by maintaining parallelity of the high-frequency knife to the muscular layer. In addition, this endoscope has dual channels, thus allowing for the selective use of the left and right forceps channels during mucosal incision and submucosal dissection, as well as maintaining suction power during procedures. This article provides a detailed explanation of gastric ESD techniques using a multi-bending endoscope.