Energy is being used with increasing frequency during endoscopy. Energy allows for the safe removal of large lesions within the upper and lower gastrointestinal tract thus avoiding the risk and recovery associated with surgery. However, the use of energy has been associated with an increased risk of complications. The most common major complications, bleeding and/or perforation, may occur at the time of procedure or in a delayed fashion, and can result in patient demise. The direct transfer of energy through the polyp and into the opposite wall of the bowel has been theorized as a mechanism of injury during polypectomy. Thus, it is recommended that endoscopists maintain complete separation between the polyp and the opposing bowel. This is not always feasible but can be partially achieved by “wiggling” the polyp during activation to avoid prolonged energy coupling between the polyp and a single location on the opposite bowel wall. The PURPOSE of this study was to quantify direct energy coupling during endoscopy and evaluate practical recommendations for its avoidance.
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© 2016 Published by Elsevier Inc.