Post written by Galen Leung, MD, from NYU Langone Health, New York, New York, Daniela Guerrero Vinsard, MD, from Minneapolis Veterans Affairs, Minneapolis, and Ryan J. Law, DO, from Mayo Clinic, Rochester, Minnesota, USA.

We are excited to present a comprehensive overview of endoscopic submucosal dissection (ESD). This Technology Status Evaluation Report provides a compendium of current devices and techniques in the practice of ESD, including specifications of electrosurgical knives, traction devices, submucosal lifting agents, electrosurgical generator settings, and tools for closure, as well as a discussion of techniques and safety of the procedure. There are plenty of figures, tables, and videos to supplement the text.

For the general gastroenterologist, it offers introductory insight into how ESD is performed and how we use many available devices in its practice. For the gastroenterologist who is interested in ESD, it can complement training in ESD, bringing in all the technologies and addressing the role they serve in the practice of ESD. For the practicing endoscopist in ESD, it is a reference specifying features among the many available technologies.

ESD has expanded tremendously in its practice, as well as its role in the management of GI neoplasia and multidisciplinary treatment of cancer. The advantage of ESD to perform en bloc resection of complex GI luminal neoplasia, as well as early cancers, allows for accurate histopathological evaluation and potential curative resection. However, the procedure is quite technically complex, and there has been a tremendous evolution over the past decade in terms of development of new devices, innovative techniques, guidelines, awareness, and a procedural billing code.

This updated Technology Status Evaluation Report reflects that growth and is a careful review of all those technologies, techniques, and existing literature. The review is both a primer and a reference to gastroenterologists to get up to speed with the technology and define the specifications of new devices.

This Technology Status Evaluation Report assists in patient care for all gastroenterologists and endoscopists. For the general referring endoscopist, this document can increase awareness of ESD and how it is performed. For the endoscopist learning ESD, this report brings all the ESD technologies together and explains how they are incorporated into each step of ESD, augmenting the training process. For the ESD practitioner, this reference details the differences among the many available devices and how they make ESD safer and more efficient, so the endoscopist can decide which devices they would like to use, supporting the way they perform ESD. This document also contains direct QR codes to practical videos that will assist endoscopists on how to set up and use diverse traction tools for ESD.

ESD is an expanding field in advanced endoscopy, and this Technology Status Evaluation Report is a summary of what ESD is, a description of the different complex techniques, and a compendium of all available devices. We hope it is helpful and enjoyable to read, whether the reader is curious about what ESD is, wants to get started in it, or is looking for an all-in-1 document for devices associated with ESD.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.