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Endoscopic Mucosal Resection (EMR) is a procedure used to remove polyps detected during endoscopy or colonoscopy. Following their identification and endoscopic/colonoscopic classification, a decision is made regarding the most appropriate removal method. The duration of the EMR procedure varies depending on the size and characteristics of the lesion. Smaller polyps, typically 1-2 cm in size, can often be resected swiftly, within 1-2 minutes. If polyps detected during endoscopy or colonoscopy meet specific criteria, the procedure may be completed without waking the patient from sedation.
Patient preparation for EMR is tailored to the location of the procedure. For lesions in the colon, bowel preparation, as advised by the physician, is necessary one day prior to ensure clear visualization, similar to a standard colonoscopy. For procedures in the esophagus, stomach, or small intestine, an 8-hour fasting period is generally sufficient. Patients must inform their doctor about any medications they are taking, including blood thinners, diabetes medications, or other ongoing medical treatments, to allow for appropriate pre-procedure planning. Prior to the EMR, the patient receives an appropriate dose of anesthesia for sedation.
The EMR procedure is performed in an endoscopy unit using a thin, flexible tube equipped with a video camera and other instruments. For lesions in the esophagus, stomach, or upper small intestine, the endoscope is inserted orally. For lesions in the colon, the tube is advanced through the anus. After the polyp has been thoroughly evaluated, its removal method is determined. The procedure involves scraping the superficial tissue in the targeted area. An essential step is the submucosal injection: a needle is passed through the endoscope to inject a fluid beneath the polyp, creating a cushion that elevates the lesion. This elevation helps to separate the abnormal tissue from deeper layers, facilitating a safer and more complete resection. The lesion's borders are then defined, and it is subsequently removed. A key feature of the endoscope used for EMR is its high resolution. Additionally, by altering light wavelengths, it can make previously invisible polyps apparent, thereby increasing the polyp detection rate.
How is EMR applied?
Patient preparation for EMR is tailored to the location of the procedure. For lesions in the colon, bowel preparation, as advised by the physician, is necessary one day prior to ensure clear visualization, similar to a standard colonoscopy. For procedures in the esophagus, stomach, or small intestine, an 8-hour fasting period is generally sufficient. Patients must inform their doctor about any medications they are taking, including blood thinners, diabetes medications, or other ongoing medical treatments, to allow for appropriate pre-procedure planning. Prior to the EMR, the patient receives an appropriate dose of anesthesia for sedation.
The EMR procedure is performed in an endoscopy unit using a thin, flexible tube equipped with a video camera and other instruments. For lesions in the esophagus, stomach, or upper small intestine, the endoscope is inserted orally. For lesions in the colon, the tube is advanced through the anus. After the polyp has been thoroughly evaluated, its removal method is determined. The procedure involves scraping the superficial tissue in the targeted area. An essential step is the submucosal injection: a needle is passed through the endoscope to inject a fluid beneath the polyp, creating a cushion that elevates the lesion. This elevation helps to separate the abnormal tissue from deeper layers, facilitating a safer and more complete resection. The lesion's borders are then defined, and it is subsequently removed. A key feature of the endoscope used for EMR is its high resolution. Additionally, by altering light wavelengths, it can make previously invisible polyps apparent, thereby increasing the polyp detection rate.