A New Pre-Sealing Technique Reduces the Use of Coagulation Forceps in Third-Space Endoscopy: One-Stop Shopping

Aims Third-space endoscopy (TSE) procedures are hampered by a significant rate of intra-procedural bleeding, affecting their duration and feasibility. The narrow field of endoscopic view and the imperfect hemostatic power of TSE devices limit effective intra-procedural hemostasis. Thus, large vessels (i.e., larger than the tip of the knife) usually required coagulation with dedicated coagulation forceps, before the subsequent dissection with the TSE knife. However, this requires device exchanges, slowing the TSE procedure and consequently increasing the risk of adverse events and the overall costs. To overcome these limits, we introduced a new technique of saline immersion (SI) vessel pre-sealing with the same knife and the same electrosurgical setting. In this study, we present the early results.