ASGE Endoscopy Live: Colonoscopy | November 2024-Endoscopy Live Case 6

Video Transcription

Video Summary

In this video, Dr. Rex performs an underwater endoscopic mucosal resection (EMR) on a 52-year-old female patient with a 30-millimeter non-granular lateral spreading tumor in the ascending colon. The discussion focuses on the nuances and advantages of underwater EMR, such as higher on-block resection rates and efficiency as it avoids injecting solutions to lift the lesion. Challenges include handling bleeding and tissue control during the procedure. The team discusses the use of saline versus water in underwater EMR, with no conclusive evidence favoring one over the other. There is also mention of snare tip soft coagulation as part of the removal process. Post-resection involves clipping the defect for proper healing and marking the area with a tattoo for later identification. The team emphasizes the importance of documenting the tattoo's placement and addressing patient follow-up challenges, highlighting regional differences in patient recall systems.

Keywords

underwater EMR

endoscopic mucosal resection

lateral spreading tumor

snare tip soft coagulation

post-resection clipping

patient follow-up