Kd 611

ESD was carried out with a single channel endoscope (GIT-H260; Olympus, Japan). Before inserting the gastroscope, a short and transparent cap (ND-201-11802, Olympus, Japan) was attached to its tip to provide a constant endoscopic view and constant tension to the connective tissue for dissection. The other equipment and accessories employed for these procedures included a hybrid Knife system (ICC 200, Erbe, Germany), an argon plasma coagulation unit (APC 300; ERBE), an injection needle (INJ1-A1; Medwork, Germany), an insulated-tip (IT) knife (KD-611; Olympus), a hook knife (KD-620LR; Olympus), and hemostatic forceps (FD-410-LR; Olympus). All the ESD procedures were performed with patients under general anesthesia. The standard ESD steps are performed as follows ( Figure 2 ). The knife and hemostatic forceps were utilized for hemostasis whenever active bleeding was detected. Argon plasma coagulation was employed to coagulate any exposed vessels to decrease the risk of delayed bleeding.