Preparation of the operating room and assistance during endoscopic submucosal dissection in the colon

Introduction. Endoscopic submucosal dissection is an effective minimally invasive technique for the removal of «difficult» epithelial neoplasms of the gastrointestinal tract. These procedures require advanced specialized equipment, strict adherence to organizational and technical standards, and coordinated teamwork within the endoscopy unit, in which the endoscopy nurse plays a crucial role. Objective. To describe the principles of operating room preparation and the specific features of assistance during endoscopic submucosal dissection in the colon. Materials and Methods. The study is based on an analysis of regulatory documents governing endoscopic procedures, including regulations of the Ministry of Health of the Russian Federation, sanitary regulations, national clinical guidelines, and international recommendations. Particular attention was paid to the requirements for operating room equipment and its preparation for endoscopic procedures in accordance with a developed checklist. Results. The paper describes the technical aspects of performing endoscopic submucosal dissection at different stages of the procedure, including lesion assessment, submucosal injection, mucosal incision, submucosal dissection, the use of traction techniques, and specimen fixation. The important role of the endoscopy nurse in assisting the endoscopist, ensuring the quality and safety of procedures, and handling modern endoscopic equipment is emphasized. Conclusion. Endoscopic submucosal dissection is a complex procedure that requires advanced technical equipment, highly trained staff, and efficient workflow organization.

endoscopy, colorectal endoscopic submucosal dissection, endoscopy nurse, assistance, checklist

1. Order of the Ministry of Health of the Russian Federation «On Approval of the Rules for Performing Endoscopic Examinations». No. 206n. dated April 14, 2025. (in Russ.)@@ Приказ Министерства здравоохранения Российской Федерации от 14.04.2025 № 206н «Об утверждении Правил проведения эндоскопических исследований».

2. Order of the Ministry of Labor and Social Protection of the Russian Federation «On Approval of the Professional Standard ‘Endoscopist». No. 471n. dated July 14, 2021. (in Russ.)@@ Приказ Министерства труда и социальной защиты Российской Федерации от 14.07.2021 № 471н «Об утверждении профессионального стандарта «Врач-эндоскопист”».

3. Order of the Ministry of Labor and Social Protection of the Russian Federation “On Approval of the Professional Standard for Nurses/Physicians”. No. 475n, dated July 31, 2020.@@ Приказ Министерства труда и социальной защиты Российской Федерации от 31 июля 2020 г. N 475н «Об утверждении профессионального стандарта «Медицинская сестра/Медицинский брат».

4. Guidelines for Equipping and Ensuring Endoscopic Examinations, approved by the Chief Freelance Specialist, Surgeon, and Endoscopist of the Russian Ministry of Health, eds. A. Sh. Revishvili. on June 16, 2023. (in Russ.)@@ Методических рекомендаций по оснащению и обеспечению проведения эндоскопических исследований, утвержденных Главным внештатным специалистом хирургом и эндоскопистом Минздрава России // А.Ш. Ревишвили 16.06.2023 г.