Endoscopic Mucosal Resection

What is it?
Endoscopic mucosal resection (EMR) is an emerging technique for the removal of large colorectal lesions. The traditional approach to the management of large polyps in the colon has been surgery.

Why is it done?
In some cases  the polyp that has been found during a colonoscopy is larger than average and requires this technique. This is generally considered the safest method for removing this sort of polyp.

What can I expect?
Endoscopic mucosal resection is usually carried out as part of a colonoscopy or flexible sigmoidoscopy. The physician will first find the polyp which has previously been detected in your colon. The physician will then assess whether EMR is the best way to remove the polyp and if so, will proceed to remove the polyp.  A special needle is passed through the colonoscope and inserted under the base of the polyp. Fluid is injected under the polyp producing a bleb of liquid which lifts the polyp off the lining of the bowel.  A wire snare (or lasso) is passed around the raised polyp. The lasso is pulled tight and an electric current is passed through the snare which cuts the polyp off and cauterises  any blood vessels. If the polyp is very large, it may be removed in a number of pieces in the same way. Once the polyp has been removed, it is retrieved so that it can be sent to the pathology lab for further analysis.  It can take up to 7 to 10 days before a result is available. Sometimes, decisions about further treatment can only be made once these results are back.

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