What is an Endoscopic Mucosal Resection (EMR)?
Endoscopic Mucosal Resection (EMR) is a minimally invasive surgical technique used to remove abnormal or cancerous growths from the mucous lining of the digestive tract, primarily the esophagus, stomach, and colon. It is a common procedure performed during endoscopy, which allows direct visualization and access to the targeted area.
EMR is typically employed for the removal of large or flat lesions, such as polyps or early-stage cancers, that have not invaded the deeper layers of the gastrointestinal wall. The procedure aims to remove the lesion along with a portion of the underlying mucosal layer, reducing the risk of cancer progression and facilitating pathological examination.
The process of EMR involves several steps:
1. Preparation: The patient is often placed under sedation or general anesthesia to ensure comfort during the procedure. The gastrointestinal tract may be cleansed before the procedure through dietary restrictions or laxatives.
2. Endoscopic evaluation: A long, flexible tube called an endoscope is inserted through the mouth or anus and guided to the target area of the digestive tract. The endoscope is equipped with a camera and specialized tools for examination and resection.
3. Marking: The boundaries of the lesion are identified and marked using various techniques, such as tattooing or injecting a colored solution, to ensure accurate resection and subsequent surveillance.
4. Injection and lifting: A liquid solution, usually saline mixed with a substance like epinephrine, is injected into the submucosal layer beneath the lesion. This raises the abnormal area, creating a cushion and facilitating its separation from the underlying tissue during resection.
5. Resection: Different techniques may be employed depending on the characteristics of the lesion. These include snaring the lesion with a wire loop and cutting it off using electrocautery or using specialized devices like a cap or band to suction and remove the lesion.
6. Pathological examination: The resected tissue is sent to the laboratory for detailed analysis to determine the nature of the lesion and to assess whether further treatment or surveillance is necessary.
7. Recovery: After the procedure, patients are observed in a recovery area until the effects of sedation or anesthesia wear off. Some mild discomfort, such as bloating or gas, may be experienced but usually subsides quickly.
EMR is generally a safe procedure with a low risk of complications. However, as with any medical procedure, there can be potential risks, including bleeding, perforation of the gastrointestinal wall, or adverse reactions to sedation or anesthesia. The healthcare team will provide instructions for post-procedure care and follow-up appointments to monitor the patient's recovery and provide further guidance.
If you have any questions or would like to schedule an appointment with one of our Endoscopy Center specialists, please call 515.875.9115.