Ablation of Barrett‘s esophagus with HybridAPC

Argon Plasma Coagulation (APC) has been used tor ablation of Barrett's esophagus for years.1-4 THE NEW FORM OF APC IN THE HYBRID TECHNIQUE In HybridAPC, APC is now combined with a waterjet function. The combined instrument allows cost-efficient, protective and effective Grade Dysplasias (LGD), HybridAPC can also be used to supplement ESD and EMR for complete ablation of conspicuous epithelium with High-Grade Dysplasias (HGD). ELEVATION AND ABLATION WITH HYBRIDAPC Prior to ablation, the mucosa is raised with the aid of the high-pressure water jet.5-8 The water cushion thus produced enables Barrett's...

02 An ablation zone forms after the APC application 02 After therapy the mucosa is completely restored Mucosa elevation with waterjet The Barrett’s mucosa is raised with the high-pressure waterjet. Elevation takes place successively and alternately with ablation. Fluid accumulates in the submucosa that serves as a protective layer for the muscle. Ablation with APC The elevated Barrett’s structure is ablated using HybridAPC by inputting higher energy than with conventional APC without a water protection layer. The plasma jet is passed in a line over the raised tissue. This generates an ablation...

The benefits of the technique ☑ T he protective cushion increases the distance to the muscle and protects it thermally ☑ T he APC penetration depth is limited, therefore the risk of stricture is minimal ☑ T he technique is effective and cost-efficient (compared with alternative techniques) ☑ A PC, as a dynamic technique, is applied over a large area or at a point (small Barrett’s islands, cardia) ☑ Neighboring healthy epithelium is preserved ☑ A PC can be applied exactly on target and also around corners, e.g. at the gastroesophageal junction Benefits of the HybridAPC probe ☑ C ost-efficient...

The equipment FOR BARRETT‘S THERAPY AND MANY OTHER THERAPIES IN THE GIT Barrett‘s ablation is just one of the applications that can benefit from the Gastroenterology Workstation with waterjet surgery, electrosurgery and APC technology. HybridKnife®, for example, is a combined instrument to resect early carcinomas in the esophagus, stomach and intestines. In the ESD (Endoscopic Submucosal Dissection) technique, HybridKnife can be used for en bloc resection. Find further applications on our website at www.erbe-med.com Gastroenterology workstation VIO® 200 D (electrosurgery) APC® 2 (argon plasma...

Settings Mucosa elevation ERBEJET® 2, Effect 40–50 Mucosa ablation PULSED APC®, Effect 2, 60 Watt Post-ablation PULSED APC®, Effect 2, 40–50 Watt References 1 Williamson JML, Almond LM, Shepherd NA, Barr H, Current management of Barrett’s oesophagus. Br J Hosp Med (Lond) 2012;73:271–77. 2 Manner H, Argon Plasma Coagulation in Barrett’s Esophagus. Video Journal and Encyclopedia of GI Endoscopy 2013,1:4–6. 3 Bate JP, Schoeman MN, Argon plasma coagulation for Barrett’s esophagus. Tech Gastrointest Endosc 2010;12:40–43. 4 Gad YZ, Zeid AA, The role of argon plasma cogulation in the management of Barrett’s...