Endoscopic mucosal resection (EMR) is, nowadays, a well-standardized therapeutic technique
for the treatment of gastrointestinal (GI) neoplasm limited to the mucosal layer.
EMR is indicated for the removal of sessile or flat polyps smaller than 2 cm or for
piecemeal removal of larger lesions [1]. Compared with EMR, endoscopic submucosal dissection (ESD) results in a higher en
bloc resection rate and lower local recurrence rate, yet ESD has high procedure-related
complication rates and is more time-consuming [2]. Especially in presence of flat lesions, grasping the lesions can be challenging.
A hybrid technique solved this problem, although it is also a time-consuming procedure
[3]. When sessile or flat lesions can be removed by EMR, one simple trick for grasping
the lesion is, after submucosal injection, to create an incision in the normal mucosa
in the fold beyond the proximal edge of the lesion where the tip of the snare will
be inserted. Afterwards the scope is withdrawn slowly until the snare is completely
open. Then the lesion can be grasped, deflating the bowel, and cut ([Video 1]).
Video 1 Incision and snaring technique for grasping and removing a colonic flat polyp.
Endoscopy_UCTN_Code_TTT_1AO_2AG
Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques
in gastroenterological endoscopy. All papers include a high
quality video and all contributions are
freely accessible online.
This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos
