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Create a Free AccountProcedures - Endoscopic mucosal resection (EMR)
Combination of rubber band traction and partial injection for effective under-gel endoscopic mucosal resection of an ileocecal valve lesion
Neoplasms on the ileocecal valve (ICV) extending into the terminal ileum complicate EMR and endoscopic submucosal dissection (ESD), resulting in lower complete-resection rates; this leads to tumor recurrence.1,2 ESD for ICV neoplasms, although feasible and effective, is time-consuming and not yet established as a standard procedure.2Wide-field endoscopic mucosal resection of laterally spreading rectal tumors using a multiband ligation endoscopic mucosal resection technique
Advanced tissue resection techniques such as EMR and endoscopic submucosal dissection (ESD) have been established as therapeutic options for the management of advanced mucosal neoplasia of the colon. EMR has been found to safely and effectively remove sessile or flat neoplasms confined to the superficial layers of the GI tract.1Endoscopic hemostatic spray for uncontrolled bleeding after complicated endoscopic mucosal resection or endoscopic submucosal dissection: a report of 2 cases
There is a significant bleeding risk after gastric endoscopic submucosal dissection (ESD) and EMR cases. This case series describes the use of an endoscopic hemostasis spray, which is not typically used to treat this type of bleeding, after multiple attempts with other modalities failed.GI endoscopic submucosal dissection using a calibrated, small-caliber-tip, transparent hood for lesions with fibrosis
To date, various methods to manage severely fibrotic lesions encountered during endoscopic submucosal dissection (ESD) have been described. In this regard, the method of dissecting the submucosa on both sides of the fibrotic area before dissecting the severely fibrotic part has been reported to be beneficial.1,2 In particular, the pocket-creation method (PCM) is considered to be a useful method for adding adequate traction to the fibrotic area by using a small-caliber-tip, transparent (ST) hood with a tapered tip and allowing the muscles to be approached in parallel.Salvage circumferential endoscopic submucosal dissection for refractory dysplastic Barrett’s esophagus
A 64-year-old woman initially underwent endoscopy for reflux symptoms and was found to have C7M8 Barrett’s esophagus with biopsies demonstrating high-grade dysplasia. She was referred to a tertiary esophageal center, which performed endoscopic mucosa resection.Underwater EMR of a colonic adenoma surrounded by diverticula
An 83-year-old man with positive fecal occult blood test results underwent colonoscopy, which revealed a 15-mm-diameter laterally spreading tumor surrounded by multiple diverticula at the ascending colon (Figs. 1 and 2). The lesion was a nongranular-type laterally spreading tumor, and the Japanese Narrow-Band Imaging Expert Team classification was type 2A, meaning no evidence of invasion; therefore, we performed endoscopic resection instead of surgery.Usefulness and safety of colorectal precutting EMR and hybrid endoscopic submucosal dissection for sessile serrated polyps with use of a novel multifunctional snare
Precutting EMR (defined as a technique in which snaring is done without dissecting the submucosal layer after the circumference of the lesion alone is incised by using a knife or the tip of a snare) and hybrid endoscopic submucosal dissection (ESD) (defined as a technique in which the submucosal layer is dissected and snaring is carried out after the ESD procedure by use of a knife for ESD or the tip of a snare) have the advantages of decreased procedure time and decreased perforation risk over conventional ESD.Tissue retractor system–assisted endoscopic submucosal dissection of a large rectal tumor with significant fibrosis from direct tattooing
Endoscopic tattooing directly into large dysplastic lesions is often performed for lesion identification before EMR or endoscopic submucosal dissection (ESD). Several case reports have demonstrated the difficulty of attempting endoscopic resection of previously tattooed lesions, primarily because of tattoo-induced submucosal fibrosis, inadequate lifting of the lesion, and obscuring of the dissection planes.1-3Precutting EMR with full or partial circumferential incision with a snare tip for the en bloc resection of difficult colorectal lesions
EMR is performed worldwide as a standard therapy for colorectal polyps. It is difficult to achieve en bloc resection by EMR for a colorectal tumor ≥20 mm; the en bloc resection rate for tumors ≥20 mm is reported to be only approximately 30%.1 Additionally, inappropriate elevation resulting from fibrosis and problematic locations can make EMR difficult, even for tumors <20 mm.Endoscopic submucosal dissection pocket technique for removal of recurrent colonic lesion
A 78-year-old woman had undergone a screening colonoscopy in 2010, which revealed an 11-mm flat lesion in the sigmoid colon. This was removed by EMR in a piecemeal fashion, and the area was tattooed. A subsequent colonoscopy in 2016 revealed a 30-mm flat lesion at the previous EMR site. She was referred to our hospital for endoscopic submucosal dissection (ESD).Endoscopic submucosal dissection by use of a modified dental floss clip method for recurrent tumor in the cecum
Endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic treatment that provides 1-piece resection of early GI neoplasms. ESD requires high endoscopic skill because it is a “1-hand” surgical procedure, meaning that it is performed without any traction except for gravity. Surgeons usually use both hands to obtain adequate traction when they use an electrosurgical knife. In the past, several traction methods have been reported.1-3 The dental floss clip (DFC) method is a newly developed traction method.
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