ESD Endoscopic Submucosal Dissection



Endoscopic Submucosal Dissection consists of several steps. The first step is usually the placement of coagulation marks around the lesion with a safety margin. This facilitates identification of the resection margin during the procedure. The AqaNife can be used for this step.  

The next step is sumucosal liquid injection to lift the mucosa from the muscular layer. Then follows the incision of the mucosa and the subsequent HF-dissection of the submucosal space with the tip of the AqaNife. 

The VersaCap, Ovesco’s new ESD cap, adapts flexibly to a range of endoscope diameters. Its soft material makes introduction and tissue manipulation easy and it supports access to the submucosal space for dissection. Lost fluid, occurring during dissection over time, can be replaced without instrument change by gently inserting the tip of the

Aqanife into the submucosa and fluid injection.

Besides the AqaNife also the Endo-Maryland Dissector can be used for tissue dissection. As in surgical dissection, the specially shaped jaws of the instrument can be applied to gently spread the tissue and bluntly dissect the submucosal space. Also bleeding can be stopped, applying the Endo-Maryland Dissector as a coagulation grasper.

Advantages of multimodal ESD (Endoscopic Submucosal Dissection)

• Multimodality means
  Combination of classical knife dissection with Endo-Maryland Dissector blunt dissection capabilities
  
  
• Comprehensive
  Ovesco delivers complete package for ESD procedure
  
  
• Safe
  - lavage of the target tissue for better overview, fast identification of bleedings
  - submucosal re-injection without instrument exchange
  - blunt spreading with Endo-Maryland Dissector facilitates keeping the dissection plane
  
  
• Efficient
  Reduction of operation time by lower instrument-replacement rate
  

ESD procedure

See also:
	ES Dissect System
	Endo-Maryland Dissector
	ESD AqaNife
	ESD AqaJet
	ESD Versacap
	Traction Polypectomy Snare