Fundamental use of surgical energy during endoscopic therapies

Knowledge of the principles of safe use of surgical energy is a critical element in the practice of any endoscopist. We review the basic principles of electrosurgical energy as taught by the Fundamental Use of Surgical Energy curriculum and then provide endoscopy-specific applications of these principles. We reviewed the basic principles of electrosurgical energy, including terminology and cellular effects of electrosurgical energy, as well as an overview of various electrosurgical instruments that are used in endoscopy. We then related the principles of electrosurgical energy to common complications seen in endoscopy (e.g., perforation, bleeding, post-polypectomy syndrome) and discussed possible techniques to maximize the safety of utilizing electrosurgical energy in procedures such as polypectomy, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic submucosal dissection, and per oral endoscopic myotomy (POEM).