TEM using ESD
Waterjet technology for ESD-TEM (transanal endoscopic microsurgery via waterjet-based endoscopic submucosal dissection)
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Dr. Jörg Baral of the Karlsruhe Municipal Medical Center presented a video at this year's ACS (October 24 – 26) on the use of waterjet technology for ESD-TEM (transanal endoscopic microsurgery via waterjet-based endoscopic submucosal dissection). In the video he shows a new approach to removing rectal adenomas that have not infiltrated the muscularis. A much gentler technique for the patient, the new surgical approach is based on the use of the ERBEJET 2 and 20150-026 applicator to perform ESD as part of a TEM procedure. |
A gentle method
The
en bloc resection of a 4.5 x 6 cm adenoma shown in the video is striking. As
the ultrasound image clearly shows, the muscularis has not been infiltrated,
and, as such, the patient meets the criteria for the application of the ESD
technique.
The rigid applicator has a curved tip and is used for elevating the submucosa. The video provides an impressive demonstration of how to elevate the submucosa and separate it from the muscularis. The cushion of water allows the surgeon to manipulate layers with great precision during the resection, thereby minimizing the risk of perforation.
Dr. Baral has now used the ERBEJET 2 for over 25 TEM procedures and is convinced that the new method offers advantages both to the patient and to the surgeon:
The rigid applicator has a curved tip and is used for elevating the submucosa. The video provides an impressive demonstration of how to elevate the submucosa and separate it from the muscularis. The cushion of water allows the surgeon to manipulate layers with great precision during the resection, thereby minimizing the risk of perforation.
Dr. Baral has now used the ERBEJET 2 for over 25 TEM procedures and is convinced that the new method offers advantages both to the patient and to the surgeon:
- The water cushion reduces the risk of bleeding
- No sutures are needed after the surgery
- En bloc resection
- A precise, safe and fast procedure
- Clear view of the operating field