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Gastro 2016
August 11-12, 2016
Volume 6, Issue 4(Suppl) J Gastrointest Dig Syst 2016
ISSN:2161-069X JGDS, an open access journal
conferenceseries .com
August 11-12, 2016 Birmingham, UK
6th Global Gastroenterologists Meeting
Mitsunori Yasuda, J Gastrointest Dig Syst 2016, 6:4(Suppl)
Strategies for safe and precise ESD
Mitsunori Yasuda1,2
1Uji Tokushukai Hospital, Japan
2Kyoto Prefectural University of Medicine, Japan
ESD, now spreading globally as therapeutic endoscopy for early malignant esophageal, stomach, and large intestinal tumors,
can excise larger lesions, less invasively, than conventional EMR and surgery. However, since ESD technical difficulties are
relatively high as compared to EMR, appropriate knowledge and skills for ESDmust be acquired. Today, I introduce and present
tips and tricks for completing safe and precise ESD. First, selection of appropriate cases based on accurate diagnosis is required,
using Image Enhanced Endoscopy such as NBI magnification or chromoendoscopy. It is necessary to correctly determine the
width and depth of lesions and thereby ascertain correct indications for ESD. Then, to safely perform procedures, suitable
endoscopes, attachments, and devices must be selected, as well as setting up high frequency electric generators. Moreover,
to uniformly excise the submucosa to a suitable layer, it is important to maintain good visual fields and proper orientation
operatively, making local injection of adequate solution, water jet function and suitable hemostatic procedures essential.
Since acquiring good operative views reduces complications, such as bleeding and perforation, and shortens operative time,
combining suitable traction methods is very useful. The clip and thread method and the clip and snare method (the later one
devised by the author) are both quite useful. Using these methods and devices properly, and combining them, and avoiding
damage to muscle layers are important for successful ESD. I will present various tips and tricks for completing safe and more
stable ESD with actual cases.
Biography
Mitsunori Yasuda has completed his MD from Kyoto Prefectural University of Medicine and completed his PhD from the same University. He is the Director of
Department of Gastroenterology and Hepatology and the Director of Endoscopy Center of Uji Tokushukai Hospital, Kyoto, Japan, and has been working as the
Professor of Department of Clinical Gastroenterology of Kyoto Prefectural University of Medicine since 2007.