Endoscopic Mucosal Resection (EMR)
Endoscopic mucosal resection (EMR) is a method of removing superficial lesions from the gastrointestinal (GI) tract. In the colon and rectum, it is used to remove precancerous lesions as well as select cases of early submucosal cancer. In this chapter, I will discuss the indications and contraindications of EMR from a Japanese perspective, describe the basic techniques of EMR and some variations of the technique, and discuss tips and tricks as well as pitfalls of the procedure.
KeywordsEndoscopic mucosal resection Snare polypectomy Strip biopsy method Submucosal colorectal cancer EMR
Video 3.1 Endoscopic Mucosal Resection (EMR) of 18 mm Polyp in the Ascending Colon: A 18 mm flat polyp (type IIa of Paris classification) is visualized in the ascending colon. The polyp is positioned at 7 o'clock. Narrow band imaging (NBI) reveals a type II lesion of NICE classification consistent with low-grade adenoma. A submucosal injection using 10 % glycerine is performed achieving a high lift of the polyp. The polyp is snared in one piece, and the EMR wound is closed with endoclips. Given the en bloc resection, a precise histopathological analysis is possible (M4V 22926 kb).