ASGE Advanced Endoscopic Lesion Resection Course (On-Demand) | November 2022-Hybrid EMR: Bringing ESD Tricks to Standard EMR

Video Transcription

Video Summary

In the video, a speaker discusses the concept of hybrid EMR (endoscopic mucosal resection) and its potential benefits in EMR practice. They explain that while EMR is generally a successful treatment for non-malignant colorectal polyps, there are limitations and challenges, particularly in cases with submucosal fibrosis or suspected invasive cancer. The speaker discusses the advantages of endoscopic submucosal dissection (ESD) in these cases, as it allows for resection and blocking of lesions irrespective of size, provides optimal pathological specimens, and has lower recurrence rates. However, ESD can be technically complex and associated with longer procedural times and higher risks. The speaker introduces the concepts of pre-cut EMR and hybrid ESD as potential strategies to still achieve resection and blocking of lesions. They provide examples and discuss data on the limitations and outcomes of these techniques. The speaker also mentions ongoing research in this field and highlights the importance of risk stratification and lesion classification in determining the appropriate technique. The video ends with a demonstration of ESD techniques for pedunculated polyps and a discussion on the challenges of tattooed lesions.

Asset Subtitle

Dennis Yang, MD, FASGE

Keywords

hybrid EMR

endoscopic mucosal resection

ESD

colorectal polyps

pathological specimens

risk stratification