Endoscopic Mucosal Resection (EMR) in Okeechobee, FL

Endoscopic mucosal resection, or EMR, is a procedure that removes large or flat polyps and early growths from the lining of the digestive tract during an endoscopy — without surgery. Instead of an operation through the abdomen, the growth is removed from inside, using the same kind of flexible scope used for colonoscopy or upper endoscopy (EGD). EMR is performed by an advanced endoscopist and is often the preferred treatment when a polyp is too large or too flat to remove with a standard snare alone. The procedure takes longer than a routine colonoscopy, because the growth must be lifted and removed carefully, but it is still an outpatient endoscopic procedure.

EMR is most often used for large or flat colon polyps found during screening or diagnostic colonoscopy. Removing these polyps completely is important, because large polyps are more likely to contain precancerous changes or early cancer. EMR can also remove large polyps and early lesions in the esophagus, stomach, and duodenum (the first part of the small intestine) when they are found during upper endoscopy. Your doctor will consider the size, shape, and location of the polyp, as well as the pathology from any prior biopsies, when deciding whether EMR is the right approach. In suitable cases, EMR avoids open surgery and even avoids removing a section of colon, while still providing tissue for the pathologist to examine.

During EMR, the endoscopist first examines the growth carefully and marks its edges. A fluid, often saline, is then injected beneath the growth through the scope. The fluid lifts the growth away from the deeper layers of the bowel or stomach wall, creating a cushion that makes removal safer. A wire loop called a snare is then placed around the lifted tissue, and the growth is cut away in one or more pieces. If the growth is very large, it may be removed in several pieces, a technique called piecemeal resection, and the area is then carefully inspected to make sure no abnormal tissue remains. The removed tissue is collected and sent to pathology, where it is examined under the microscope to confirm the diagnosis and to check that the edges are clear.

Because EMR is done during a colonoscopy or an upper endoscopy, the preparation and sedation are the same as for the underlying procedure. For colon EMR, that means a bowel preparation beforehand; for upper endoscopy, it usually means fasting. The procedure is done with sedation, so you will be comfortable and will need someone to drive you home. Most patients go home the same day. Mild cramping or bloating afterward is common and usually settles quickly; serious bleeding or perforation is uncommon but is a recognized risk that your doctor will discuss with you before the procedure. Our office will confirm the specifics for your case, including preparation instructions, what to expect afterward, and when your pathology results will be ready.

The main benefit of EMR is that it treats a significant growth without surgery, with a shorter recovery and fewer risks than an operation. It also gives a complete specimen for pathology, so your doctor knows exactly what was removed. Learn more about colon polyps and colon cancer screening. To discuss whether EMR is appropriate for you, call Gastro in Florida at (863) 824-3447.