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Endoscopic Mucosal Resection (EMR)

Endoscopic mucosal resection (EMR) is an outpatient procedure that lets physicians remove tumors just beneath the gastrointestinal (GI) wall without surgery. Using an endoscope — a flexible, tube-like instrument — our gastroenterologists (physicians who specialize in treating the GI tract) can see inside the body with a high degree of detail. At the same time, they can remove growths such as upper GI or colon polyps that might otherwise require surgery.

Most patients return home the same day. Because there is no incision, you may recover faster, and with less pain, than from open or laparoscopic surgery.

Endoscopic Mucosal Resection: Why It’s Performed

Our gastroenterologists are specially trained in EMR. They may use EMR to remove some precancerous and early-stage cancers from the esophagus or colon wall (the mucosa). EMR is most effective for tumors that:

  • Have not yet reached deeper layers of the GI wall
  • Are larger than 2 centimeters

In cases where the tumor has reached deeper layers, our gastroenterologists may instead use endoscopic submucosal dissection or endoscopic full thickness resection.

EMR may treat:

  • Barrett’s esophagus
  • Precancerous or superficial cancerous tumors such as gastric or small bowel lesions (areas of abnormal tissue)
  • Early-stage esophageal cancer or colon cancer

Endoscopic Mucosal Resection: How to Prepare

Before your EMR:

  • For a lower GI tract procedure, follow a liquid diet plus a laxative or enema to cleanse the bowel.
  • For an upper GI tract procedure, do not eat or drink for 12 hours before the procedure to ensure your esophagus is clear of food products.
  • Tell your doctor if you have any allergies.
  • Follow your doctor’s instructions about whether to take your prescription medications.

Endoscopic Mucosal Resection: What to Expect

On the day of your procedure, you will arrive at the endoscopy unit three or more hours before the procedure. You will register and provide your medical history, including any medications you have taken. Please arrange for someone to drive you home after your procedure.

During the procedure, your gastroenterologist will:

  1. Insert an IV to deliver a sedative that will make you drowsy.
  2. Place a high-definition endoscope through your mouth or your anus, depending on the location of the tumor. Your doctor will observe the images on a screen.
  3. This helps avoid damage to surrounding tissue during the procedure.
  4. Sometimes apply suction to the top of the tumor, further lifting it up and away from other tissue.
  5. Feed a thin wire rope through the endoscope and place it around the base of the tumor. An electrical current in the wire will “cut” the tumor from the body and seal the cut at the same time.
  6. Retrieve the tumor by suction or a specialized retrieval tool through the endoscope.
  7. Pull the tissue through the endoscope to remove it. A laboratory examination will confirm that the procedure completely removed the tumor.

After the procedure, we will monitor you in a recovery room while the sedative wears off. Your doctor will discuss your results with you before you leave.

Common side effects may include:

  • Sore throat
  • Nausea or vomiting
  • Excessive gas, bloating or cramping

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