ABSTRACT

Introduction

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 Ampullectomy. 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, 60 W) 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.

中文翻译：

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胃肠道内窥镜检查中的电外科手术装置：实践的正确设置

摘要

介绍

电外科设备 (ESU) 是内窥镜设备的组成部分。正确了解模式和设置对于良好的治疗效果和患者的安全至关重要。

覆盖领域

ESU产生高频电流，可以进行切割和凝固以进行各种治疗干预。我们回顾了常见内镜干预措施（如止血、息肉切除术、括约肌切开术）和高级手术（如内镜超声引导下的膀胱胃造口术、胆管引流和内镜壶腹部切除术）的正确设置。我们回顾了内窥镜检查实践中 ESU 的各种波形，包括带有起搏器的患者等特殊情况。

专家意见

了解波形的占空比和波峰因数是必要的。高占空比和较低的波峰因数可对组织产生良好的切割效果。Endocut 是 ESU 内镜手术（如括约肌切开术和息肉切除术）中最常用的模式。Endocut I 模式（效果 1-2、持续时间 3、间隔 3）用于内镜下括约肌切开术，而强制凝固模式（效果 2、60 W）控制括约肌切开术后出血。Endocut Q 模式（效果 2-3，持续时间 1，间隔 3）用于切割息肉，而强制凝固模式（效果 2，60 W）用于切割前对息肉进行预凝固。