Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection

Figure 1 Process of the vessel-sealing with endoknife compression technique. A: The vessel penetrating between the muscularis propria is exposed; B-D: The vessel is compressed by the FlushKnife-BT 2.5 mm and coagulated using the S method or F method until the color turned white, which indicates a complete desiccation of the vessel. If it does not turn white completely, we tried this method from the other side; E and F: Finally, the vessel is cut with the FlushKnife-BT 2.5 mm using the forced coagulation mode (Effect 3, 50 W).

Figure 2 Evaluation of coagulation by an ex vivo model. A: The FlushKnife-BT 2.5 mm was placed on the fresh pork block and lightly pressed by the transparent glass to apply even pressure to each tip; B: The 3-mm ball tip electrodes were used to investigate the width and depth of the coagulation.

Figure 3 Vessels processed by the vessel-sealing with endoknife compression.

Figure 4 Time-dependent HF power in F1-10 and S methods measured by the VIO DOKU.

Figure 5 Macroscopic view after coagulation by the ball electrode with a 3-mm tip and microscopic view after coagulation by the FlushKnife-BT in the porcine block. A: Macroscopic view of the front surface after coagulation using the ball electrode with a 3-mm tip. The coagulation at the left and right is the result of the F1-10 and S methods, respectively; B: Macroscopic view of a transverse section after coagulation using the ball electrode with a 3-mm tip; C: Microscopic view of the hematoxylin-eosin staining after coagulation by the FlushKnife-BT 2.5 mm. The coagulation at the left and right is the result of the F1-10 and S methods, respectively.