Colonoscopy Endoscopic Mucosal Resection

Endoscopic Mucosal Resection (EMR) is a specialized procedure performed during a colonoscopy to remove abnormal or precancerous lesions from the mucosal lining of the colon. EMR is particularly useful for treating large or flat polyps, early-stage colorectal cancer, and dysplastic lesions that are confined to the mucosa (the innermost layer of the colon wall).

Procedure Overview

During a colonoscopy, the physician inserts a flexible tube with a camera (colonoscope) into the colon. If abnormal growths, such as large polyps or early-stage cancer, are detected, EMR is performed to remove the lesion while preserving the surrounding tissue.

• Preparation: The patient undergoes bowel preparation to clear the colon, usually involving fasting and the use of laxatives. Sedation is given for comfort during the procedure.
• Injection: A saline solution, often mixed with epinephrine, is injected under the lesion. This lifts the lesion from the underlying tissue and creates a cushion, which makes it easier and safer to remove the lesion.
• Resection: The lesion is excised using a snare or specialized tool that is passed through the colonoscope. Electrocautery may be used to stop any bleeding during the resection.
• Specimen Retrieval: The excised tissue is collected and sent for histopathological examination to confirm the diagnosis and assess the completeness of the resection.

Benefits and Risks

• Benefits: EMR is minimally invasive, preserving healthy tissue while removing abnormal lesions. It allows for early intervention in cases of precancerous or cancerous lesions, improving patient outcomes.
• Risks: While EMR is generally safe, risks include bleeding, perforation, and infection. Post-procedure surveillance may be necessary to ensure complete removal.