Instruments for endoscopic submucosal dissection - a modern low-traumatic means of removing tumors

Previously, the main method of treating gastrointestinal tumors was resection (removal of a part of the organ). However, such surgical interventions are traumatic and can have delayed consequences for the patient. They also increase the risk of bleeding.

The EMR technique, in which the mucous membrane is captured and removed using an endoscopic snare, is suitable only for tumors that are well visualized and protrude into the organ lumen. However, some tumors of the esophagus, stomach, and intestines are flat, so it is not possible to remove them with a loop. In such situations, surgeons use the ESD method - endoscopic submucosal dissection.

The main endoscopic dissection instruments are electrosurgical electrodes and forceps. They significantly reduce the risk of bleeding and shorten the recovery period after surgery. Other surgical instruments for ESD include needles, spray catheters, and endoscopic scissors.

For clear visualization of the tumor, the doctor first performs chromoscopy with a spray catheter - stains the tissues of the pathological area. Then he applies the marks with electrocoagulation forceps. This helps to delineate the boundaries of the tumour and reduce the risk of bleeding during surgery.

Using an endoscopic needle a solution is injected into the submucosal layer to increase the volume of the tumor. And only after that, the mucous and submucosal layers are dissected sequentially with an endoscopic knife. Different electrosurgical electrodes - square, spherical, cylindrical, and ball type. Since bleeding always occurs during surgery, surgeons eliminate it with the help of hemostatic forceps.

Surgical electrodes Alton Medical are high-quality instruments that are compatible with the most flexible endoscopes.

Disposable endoscopic submucosal dissection instruments - basic electrosurgical electrodes

To perform a high-quality submucosal dissection, surgeons use electrosurgical electrodes. Preference is given to disposable endoscopic equipment, as these knives come into direct contact with tissue and blood and, if used repeatedly, can cause infection in patients.

Disposable ESD instruments Alton Medical are free of these drawbacks. They are delivered in a sterile container, unpacked immediately before the intervention, and disposed of after the operation.

Disposable endoscopic submucosal dissection instruments are represented by the following electrodes:

• Cylindrical type square knifeIt is a standardized shape that allows for efficient surgery without rotating the knife.
• Cylindrical type tunneling knife. It has a needle tip that allows for picking up submucosal fibers and making a precise cut.
• Ball type IT knife. It is easy to make lateral incisions and provides improved submucosal dissection. It can be filled with water.
• Ball type knife. It is used to cut off polyps and coagulate blood vessels using high-frequency electric current, as well as to mark tumors.