ENDOSCOPIC MUCOSAL RESECTION
Endoscopic mucosal resection (EMR) is a relatively new technique using specialized endoscopic equipment to remove nodules and relatively large areas of abnormal gastrointestinal mucosa (surface lining) that are difficult to remove through standard biopsies or other techniques. EMR is used to excise abnormal growths in the esophagus, stomach and colon.
For the esophagus a specialized plastic cap is placed on the end of an endoscope. The scope is passed into the esophagus. Using suction, the physician draws the abnormal mucosa into a plastic cap. A band is then deployed from the outside of the cap around the tissue, creating a “polyp” of tissue. A snare is then passed through the scope to encircle the polyp. Using coagulation electric current the “polyp” is removed. The polyp is then gathered into the EMR cap by suction, and the scope and specimen is removed. An advantage of the technique is when the tissue is removed, a pathological examination can be used to determine the depth of abnormal cells. This helps in diagnosing the extent and depth of invasion of the disease.
This technique can be repeated approximately five times if needed. It allows us to remove large amounts of the mucosal surface safely and effectively, without resorting to surgical procedures. The large specimens obtained also significantly improve our ability to examine tissue changes, allowing us to plan for the patient’s individual therapy in a much more accurate way.
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