2023 Senior Fellows Program (2nd & 3rd Year) | August 2023-Hands On Demo: Introduction to EMR, Cold and Hot Snare Techniques

Video Transcription

Video Summary

In this video, the presenters demonstrate a band endoscopic mucosal resection (EMR) procedure using a pig model. They use a Fuji 1T scope and show the endoscopic view as they advance it down the esophagus and into the stomach. They explain that band EMR is commonly used for resecting nodular lesions in the foregut, particularly in cases of Barrett's esophagus where deeper dysplasia cannot be excluded. They demonstrate the use of the Boston Captivator EMR system, attaching the cap to the endoscope and deploying the band onto the targeted tissue. They also show the use of a snare to resect the banded tissue. The presenters emphasize the importance of ensuring that the snare does not knock off the band and that the snare is closed below the level of the band to ensure a good resection. They also discuss the use of submucosal injection and the need for careful cautery during the procedure. After demonstrating the band EMR procedure, the presenters also show the use of a mantis clip to close a perforation and reinforce the closure with additional clips. They explain that using a mantis clip as the primary closure followed by other clips is an effective way to close defects. The presenters also address questions from the audience regarding the use of cold snare for EMR and whether a clip is necessary after band EMR. They conclude the video by preparing for the next demonstration.

Asset Subtitle

Karen L. Woods, MASGE and Ronald P. Kotfila, MD

Keywords

band endoscopic mucosal resection

EMR procedure

Fuji 1T scope

Barrett's esophagus

snare resection

submucosal injection

cautery

mantis clip