Polypectomy with ENDO CUT® Q

Removal of tumors in the gastrointestinal tract using the fractionated cutting mode

Indications

  • Polyps < 2 cm (flat, raised lesions, sessile, waisted or stalked polyps)

Advantages of ERBE equipment

  • Precise and fast initial cut with Power Peak System
  • Alternating cut and coagulation cycles
  • Safe hemostasis together with a low risk of perforation
  • Individual adjustment of the cutting duration and of cutting intervals
  • Configurable and reproducible staunching of bleeding (4 effect settings)

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Recommended products

VIO® 200 S

10140-400

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VIO® 200 D

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Operation steps
Elevating the lesion

Elevating the lesion

An important precondition for a successful and safe polypectomy or mucosal resection is elevation of the lesion (the polyp or mucosa) so that it stands out clearly from the muscularis propria (lifting sign) using the electrosurgical snare.

Placing the electrosurgical snare

Placing the electrosurgical snare

The snare should be placed around the lesion parallel to the intestinal wall, pressing lightly against the wall; the snare should then be closed slowly and lifted up parallel to the intestinal wall (fig. left). It is important to avoid one-sided tissue contact of the snare tip to the intestinal wall (fig. right).

Placing the electrosurgical snare II

Placing the electrosurgical snare II

Visual control of the grasped tissue is important: if too much tissue has been grasped (including part of the wall) the snare should be opened and less tissue should be grasped (a). It is important to avoid to much traction on the electrosurgical snare as this will lead to mechanical excision of the lesion without coagulation and therefore increase the risk of bleeding.

Ablation of stalked polyps

Ablation of stalked polyps

Stalked polyp in the colon after being grasped by the snare (fig. left). Slight coagulation at the base of the polyp after polypectomy (fig. right - white area at 11 o’clock). Stalked (pedunculated) polyps between 5-15 mm in size (polyp head) can be ablated using either the FORCED COAG mode or ENDO CUT Q. The polypectomy snare should be positioned close beneath the head of the polyp at a distance from the intestinal wall. Large stalked polyps (> 15 mm) are generally associated with a higher risk of bleeding. During the resection of large stalked polyps with ENDO CUT Q we recommend carrying out bleeding prophylaxis either by submucosal injection, electrosurgical preconditioning, or by clipping.