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Create a Free AccountProcedures - Polypectomy
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.Underwater EMR with submucosal lift for a small intestinal polyp in a patient with Peutz-Jeghers syndrome
Underwater EMR is considered an alternative technique to standard polypectomy in the management of difficult cases. This method has been reported to be effective for treatment of duodenal and colonic polyps. However, the efficacy and safety of underwater EMR for small intestinal polyps are still unknown.Usefulness and safety of a scissors-type knife in endoscopic submucosal dissection for nonampullary duodenal epithelial tumors
Duodenal endoscopic submucosal dissection (ESD) is considered challenging because of poor endoscopic operability. Furthermore, the muscle layer of the duodenum is thinner than that of any other site in the GI tract, resulting in higher reported perforation rates of up to 30%.1-3 To prevent the risk of adverse events (especially perforations) associated with the use of a conventional knife in ESD for nonampullary duodenal epithelial tumors (NADETs), we used a scissors-type knife, a stag beetle (SB) Knife Jr (Sumitomo Bakelite Co, Tokyo, Japan), which maintains an adequate dissection layer and a controlled cut that prevents unexpected muscular layer injuries.Rectal polyp reaching the dentate line: underwater EMR without submucosal lift
A rectal polyp reaching the dentate line (RPDL) is challenging to resect. Traditionally, such polyps are referred for surgery, and patients are offered either major abdominoperineal resection (with a high rate of adverse events) or minimally invasive transanal endoscopic microsurgery (TEMS). Endoscopic submucosal dissection can also be technically challenging, with a steep learning curve and rates of adverse events of 2% for bleeding, 4% for perforation, and 4% for recurrence.1 EMR of an RPDL is technically difficult, although it results in fewer adverse events than does TEMS, but it has a higher recurrence rate (32% vs 10%).
