ESD技术在结直肠的应用

Coagrasper

Model FD-411QR/UR

Basic specifications

Distal end

Cup opening width: 4 mm
Retracted — 0.3 mm
Cutting knife diameter: ø0.4 mm (except tip)

Sheath

Max. insertion portion diameter: ø3.1 mm
Working length:

FD-411QR — 1,950 mm
FD-411UR — 2,300 mm

Electrosurgical settings and tips on using the Coagrasper

Dr. Shinji Tanaka	Electrosurgical unit	ICC-200	Cautions and Tips on Use
	Haemostasis	Soft Coag., 50 W	●The colon wall is thin and delayed perforation may occur if a wide area of the muscle layer is grasped. Try to grasp only a small point on the blood vessel itself as precisely as possible. ●If it is necessary to grasp the muscle layer, it should be grasped in such a way that you are grasping only the inner circular muscle. The muscle layer should be lifted slightly toward the inner side of the intestinal tract before activation. The most important thing with the colon and rectum is to avoid excessive activation. ●A scope with a water jet function is also essential in colorectal ESD to confirm the bleeding site and remove blood.

Dr. Naohisa Yahagi	Electrosurgical unit	VIO-300D	Cautions and Tips on Use
	Haemostasis	Soft Coag., Effect 5, 50 W	●After rinsing the bleeding point with water and confirming its position, grasp the blood vessel, holding it at a single point. ●Grasp only the blood vessel, not the muscle layer. Lift the vessel slightly before activation.

Dr.
Yoshiro Tamegai

Electrosurgical
unit

VIO-300D

Cautions and Tips on Use

Haemostasis

Soft Coag., Effect 5, 50 W

●It is important to avoid excessive activation of the muscle layer as this could result in delayed perforation.
●Identify the bleeding point clearly, grasp the blood vessel at a single point, pull and apply intermittent activation for haemostasis. Avoid excessive activation of the muscle layer. Stop activation when the tissue around the bleeding point becomes white. When performing haemostasis on a perforator that penetrates to the muscle layer, restrict activation at a point before tissue whitening reaches the muscle layer.

For Safer and More Appropriate Use

Information on this page provided by Olympus

Basic Operation of Coagrasper

1 Push the slider to open the cups.

2 Rotate the entire handle to adjust the orientation of the grasping forceps (clockwise rotation is smoother than counterclockwise rotation).

3 Guide the grasping forceps to the target region and grasp it. Lift the grasped tissue gently and supply high-frequency current.

Applicable forceps channel diameters

The Coagrasper for upper gastrointestinal applications (FD-410LR) can be used with a scope that has a channel diameter of 2.8 mm or more. The Coagrasper for colorectal use (FD-411QR/UR) should be used with a scope that has a channel diameter of 3.2 mm or more.

Why the applicable channel diameters are different

The Coagrasper for colorectal use (FD-411QR/UR) has a long working length. When it is inserted into a colonoscope while it is angulated, heavy pressure applied to the proximal end will cause deflection of the sheath. To prevent this, the proximal end of the sheath is coated with a reinforcing sheath, which increases the outer diameter of this part of the Coagrasper.