Electrosurgical unit in GI endoscopy: The proper settings for practice

Expert Rev Gastroenterol Hepatol. 2023 Jul 27. doi: 10.1080/17474124.2023.2242243. Online ahead of print.ABSTRACTINTRODUCTION: Electrosurgical unit (ESU) is integral to the endoscopy unit. The proper knowledge of the Mode with setting is essential for good therapeutic outcomes and the safety of the patients.AREAS COVERED: ESU generates high-frequency electric current, which could perform cutting and coagulation for various therapeutic interventions. We review the proper settings for common endoscopic interventions like hemostasis, polypectomy, sphincterotomy, and advanced procedures like endoscopic ultrasound-guided cysto-gastrostomy, bile duct drainage, and endoscopic pulpectomy. We review the various waveforms of ESU in practice in endoscopy, including special conditions like patients with pacemakers.EXPERT OPINION: Knowledge of the waveforms' duty cycle and crest factor is necessary. A high-duty cycle and lower crest factor lead to a good cutting effect on the tissue. Endocut is the most commonly used Mode in ESU in endoscopic practices like sphincterotomy and polypectomy. Endocut I mode (effect 1-2, duration 3, interval 3) is used for endoscopic sphincterotomy, while Forced Coag mode (Effect 2, 60W) controls post-sphincterotomy bleeding. Endocut Q mode (Effect 2-3, duration 1, interval 3) is used for cutting the polyp, while Forced Coag mode (Effect 2, 60 W) is used before cutting for pre-coagulation of the stalk.PMID:37497836 | DOI:10.1080/17474124.2023.2242243
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Authors: Source Type: research