Devitalization with APC

ERBE APC 2 - even more versatile with increased control and safety

Devitalization with APC
Devitalization with APC leads to thermal damage of the tissue. In the past few years endoscopic procedures, such as the use of APC, have come into use for example for the treatment of Zenker’s diverticulum. The ERBE APC 2 is a safe and effective tool for this treatment. Compared to other methods (laser, electrocautery using forceps or a needle-knife) Argon-Plasma Coagulation offers the advantage of a better hemostasis.

Indications

  • Adenoma remnants (after polypectomy or EMR procedures)
  • Barrett’s esophagus
  • Zenker’s diverticulum

Advantages of ERBE equipment

  • Safe, effective and rapid coagulation, even of larger areas
  • Limited penetration depth, may therefore also be used in areas where there is a risk of perforation
  • Minimal carbonization, better wound healing
  • No vaporization, minimal risk of perforation
  • Non-contact procedure, therefore no adhesion of the probe to the tissue
  • Axial, radial or lateral application possible
  • Cost-efficient equipment

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Operation steps
Devitalization of adenoma remnants (after polypectomy or EMR procedures)

Devitalization of adenoma remnants (after polypectomy or EMR procedures)

After a polypectomy procedure or endoscopic mucosal resection (EMR) of adenomatous lesions, there will often still be some tissue remnants along the edge of the resected area, particularly after a piecemeal EMR procedure. APC has become a simple, quick and effective method to treat such small residual lesions, either during the same endoscopic session or during a follow-up examination to prevent or delay any recurrences. Fig.: APC-treated residual adenoma in the colon after endoscopic resection (EMR).
Barrett’s esophagus

Barrett’s esophagus

Thermoablative procedures for the removal of precancerous Barrett’s esophagus have not yet been sufficiently validated and are currently the subject of further clinical studies. However, APC does have a role to play in the removal of non-neoplastic, residual Barrett’s mucosa after endoscopic removal of an early carcinoma to prevent formation of malignant secondary lesions. APC can also be used in such lesions for ablation of tumors which cannot be removed by repeat endoscopic resection, and for the ablation of small tumor residues along the resection margins after endoscopic resection.
Zenker’s diverticulum

Zenker’s diverticulum

In addition to open surgical procedures, in the past few years various endoscopic procedures, including the use of APC, have come into use for the treatment of Zenker’s diverticulum. Compared to other methods (laser, electrocautery using forceps or a needle-knife) APC offers the advantage of a better hemostasis. The attachment of a cap to the tip of the endoscope as well as the placing of a stomach tube can help to improve visualization of the anatomical situation. An average of 2 – 3 sessions is usually required.