Watch a comprehensive video demonstrating the use of DiLumen EZ-Glide for bidirectional traction during a colorectal endoscopic submucosal dissection (ESD). This video provides a step-by-step guide, showcasing the technique's benefits in achieving precise and effective resection, reducing procedural complexity, and improving patient outcomes.
Bidirectional traction method in colorectal ESD. My name is Hamid Rahman and I will be presenting on behalf of my colleagues. These are the disclosures from our team and these are the list of the equipments that we have used in our case. Endoscopic submucosal dissection is associated with a long procedural time and adverse events due to its technical difficulty. Different traction techniques have been developed to facilitate reducing the time of the procedure and risk of adverse events. Most of the classical traction methods are static and in a single plane, double balloon over platform can be used to facilitate access and maintain stability during colonic therapeutic procedures. In our case, we introduce a new modality of traction which is bidirectional and dynamic using a double balloon over to platform. The lesion was assessed with white light imaging NBI and Indigo on forward view and on retro reflection. Dubin facilitated a stable access to the lesion site and there was a 1 to 1 movement between the colonoscope and the lesion. After proper assessment of the lesion, a lifting solution was injected underneath the polyp. A flash knife was used for marking the lesion and for cutting and trimming the mucosa around the lesion. The colonoscope was retrieved in the middle of the procedure through the dilution to change the straight cap to a conical cap to perform submucosal dissection. The reinsertion of the colonoscope back through the dilution to the lesion site took only 45 seconds to facilitate the dissection of the lesion. Bidirectional traction was applied. Firstly, a clip with a band was applied to the mucosa of the lesion On the anal side, the oral balloon of the din was pushed forward towards the sea. The clip band was then attached to the suits of the oral balloon, pushing the balloon further stretched the lesion on the anal side. This made the dissection of the lesion on the anal side a lot easier on retro reflection. The old balloon was pulled back slightly. Similarly, a clip band was applied to the mucosa of the lesion. The band was then attached to the searches of the oral balloon on pulling the oral balloon backwards further, it stretched the anal side of the lesion. And this facilitated dissection smoothly which was initially carried with the it nano knife and flush knife. The lesion was finally removed and retrieved with the dilution from the patient successfully. The lesion site was inspected and pursat was applied to the surface of the resection site to prevent delayed bleeding. A double balloon over tube platform can facilitate colorectal ed of proximal lesions by improving stability and access act as a conduit and allow traction in forward view. And in retro reflection in a dynamic bidirectional method, bidirectional traction method can facilitate dissection during ESD by providing better cutting plane view of both oral and anal side of dissection plane. The main advantage of a dynamic bidirectional traction compared to static traction is that the degree of traction can be adjusted according to the dissecting plane.
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