Grundlagen der Hochfrequenz-Chirurgie – Teil 2: Anwendungen in der Endoskopie

Zusammenfassung

Hochfrequenz-Chirurgie ist die Anwendung von hochfrequentem elektrischem Strom auf biologisches Gewebe mit dem Ziel eines thermischen Effekts, der medizinisch nutzbar ist. Diese Technik wird bei einer Vielzahl von Eingriffen angewendet und ist aus der modernen Medizin nicht mehr wegzudenken. Elektrochirurgisches Basiswissen sollten alle in der Endoskopie tätigen Mitarbeiter aufweisen. In diesem Beitrag werden die wichtigsten Anwendungsgebiete der Hochfrequenz-Chirurgie auf anschauliche und systematische Weise erklärt.

Abstract

Electrosurgery is the use of high-frequency electric current on biological tissue with the goal of creating a thermal effect that is medically useful. This technology is applied for a large number of interventions and has become indispensible in modern medicine. This article will describe the most common applications of radio-frequency associated surgery in a clear and comprehensive manner.

Schlüsselwörter

Hochfrequenz-Chirurgie - Polypektomie - Mukosaresektion - Papillotomie - Blutstillung - Argonplasmakoagulation - Devitalisierung - Tumorablation

Key words

Electrosurgery - polypectomy - mucosa-resection - papillotomy - haemostasis - argon-plasma-coagulation - devitalisation - tumour ablation

• Literatur

• 1 Neugebauer A, Zenker M, Enderle MD. Grundlagen der Hochfrequenz-Chirurgie – Teil 1: Geräte, Instumente und Einstellungen. Endo heute 2012; 25: 8-13
• 2 Heldwein W, Dollhopf M, Rösch T et al. The Munich Polypectomy Study (MUPS): Prospective Analysis of Complications and Risk Factors in 4000 Colonic Snare Polypecomies. Endoscopy 2005; 37: 1116-1122
• 3 Zauber AG, Winawer SJ, O’Brien MJ et al. Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths. N Engl J Med 2012; 266: 687-696
• 4 Ono H, Kondo H, Gotoda T et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut 2001; 48: 225-229
• 5 Soetikno RM, Gotoda T, Nakanishi Y et al. Endoscopic mucosal resection. Gastrointest Endosc 2003; 57: 567-579
• 6 Espinel J, Pinedo E, Rascarachi G. Endoscopic mucosal resection with a multiband ligator for the treatment of Barrett’s high-grade dysplasia and early gastric cancer. Rev Esp Enferm Dig 2009; 101: 403-407
• 7 Moss A, Bourke MJ, Tran K et al. Lesion isolation by circumferential submucosal incision prior to endoscopic mucosal resection (CSI-EMR) substantially improves en bloc resection rates for 40-mm colonic lesions. Endoscopy 2010; 42: 400-404
• 8 Takeuchi Y, Uedo N, Iishi H et al. Endoscopic submucosal dissection with insulated-tip knife for large mucosal early gastric cancer: a feasibility study. Gastrointest Endosc 2007; 66: 186-193
• 9 Repici A, Hassan C, De Pessoa D et al. Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy 2012; 44: 137-147
• 10 Schumacher B, Charton JP, Nordmann T et al. Endoscopic submucosal dissection of early gastric neoplasia with a water jet-assisted knife: a Western, single-center experience. Gastrointest Endosc 2012; 75: 1166-1174
• 11 Yahagi N, Neuhaus H, Schumacher B et al. Comparison of standard endoscopic submucosal dissection (ESD) versus an optimized ESD technique for the colon: an animal study. Endoscopy 2009; 41: 340-345
• 12 Freeman ML, Guda NM. ERCP cannulation: a review of reported techniques. Gastrointest Endosc 2005; 61: 112-125
• 13 Conway JD, Adler DG, Diehl DL et al. Endoscopic hemostatic devices. Gastrointest Endosc 2009; 69: 987-996
• 14 Manner H, Enderle MD, Pech O et al. Second-generation argon plasma coagulation: two-center experience with 600 patients. J Gastroenterol Hepatol 2008; 23: 872-878
• 15 Manner H, Plum N, Pech O et al. Colon explosion during argon plasma coagulation. Gastrointest Endosc 2008; 67: 1123-117