Refining Colorectal ESD Techniques with DualKnife J

✔　Disk shaped knife tip enabling hooking and cutting even the situation where the muscle layer stands perpendicularly.

✔　Stable, effective dissection was achieved even for challenging situations such as rich fatty tissue or submucosal hematoma.

✔　Hemostasis and vessel management achieved by coagulating with DualKnife J.

✔　Switching to an approach from the lateral toward the center by pulling back the knife, like dissection with an ITknife can sometimes be effective when the muscle layer is close to the target tissue in a narrow space.

✔　Aim the appropriate injection site

• Avoid injury of the blood vessel

• Target the loose submucosal layer just above the muscle layer

✔　Strongly contacting the tip of the ceramic is the secret for effective injection with DualKnife J, since injection solution is coming from the tip of the ceramic sheath

✔　Using coagulation current very shortly and pushing the sheath into the tissue for reducing the space between the knife and the submucosal layer enables effective injection.

✔　Advantage of Water Pressure Method contributing to safe and effective submucosal dissection.

• Stable visualization of the submucosal layer from initial submucosal dissection. 

• Facilitated identification of the submucosal layer, differentiated from vessel, fat tissue, muscle layer.

• Hooking the tissue edge facilitated by water jet.

✔　DualKnife J demonstrates good cutting capability underwater due to its high electro density.
       Changing electrosurgical unit setting from under air condition is not necessary.