EMR is an endoscopic procedure for resecting sessile or flat lesions that, limit to the mucosa and submucosa. Usually, EMR is carried out in combination with supportive techniques, such as elevation or suction
EMR-Endoscopic Mucosal Resection
When high-pressure elevation using the flexible waterjet probe, fluid accumulates in the submucosa and forms a fluid cushion. This selective cushion, which is limited to the submucosa, creates a safety distance to the muscular, thus minimizing the risk of perforation during snare resection.
The fluid can replenish as required. Only lesions up to approx. 20 mm in size resects en bloc using the EMR snare technique – dependent on the snare size. For larger diameters, the snare is applied several times employing a piecemeal technique.
The disadvantage of the piecemeal technique is the higher recurrence rate for some tumor types and the fact that it makes histological evaluation more difficult for the pathologist.