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Gastrointest Endosc Clin N Am. 2014 Apr;24(2):183-9. doi: 10.1016/j.giec.2013.11.008. Epub 2014 Feb 13.

Electrocautery for ESD: settings of the electrical surgical unit VIO300D.

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Department of Gastroenterology, Kobe University School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Electronic address:


An electrical surgical unit (ESU) performs incisions and coagulation through applying Joule heat, generated by a high-frequency current onto tissue without neuromuscular stimulation. Output by the ESU includes incision output and coagulation output. Incision output is needed to generate a steam explosion (spark) by quickly increasing the intracellular fluid temperature through continuous application of Joule heat generated by the high-frequency current (unmodulated pulse: continuous wave). To perform safe and successful endoscopic submucosal dissection, one must fully understand the principles and features of an ESU to use settings that match the device and to adjust the settings appropriately for each situation.


Electrosurgical unit; Endoscopic submucosal dissection; Power peak system; VIO300D

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