Bleed management during endoscopic therapy Part 2 – Soft tip Coagulation with Snare

​Bleed management during endoscopic therapy – Part 2 – Soft tip Coagulation with Snare

See below short video of mild ooze post Cold snare polypectomy, which did not subside on its own. Its rare to see continued on going bleed post Cold snare. In this case, I noticed continued ooze on extubation atleast 5 mins post cold snare. A clot had already formed and despite this there was ongoing ooze.

​Some tips

1. As previously, Position the patient so that bleeding point lies opposite to gravity – this allows blood to pool away from bleed point and improves visibility
2. Expose the vessel by removing the clot before treating – you can use  snare/roth net or simple suction may help
3. In minor ooze like this, no need to reach out to expensive Coag graspers, clips etc, simple use of snare tip with Soft coagulation mode 60-80 W on ERBE diathermy would suffice to coagulate the vessel by applying pressure against the bleeding point
4. Note that constant irrigation helps to get clear view of the bleeding point for effective hemostasis
5. If this does not work , can reach out to Coag Graspers or hemostat forceps or clips