Masterclass: EndoQuest - Endoscopy in the GI Unit (On-demand) | September 2025-Precision in Practice: Understanding Endoscopy Tools for Polypectomy and EMR

Video Transcription

Video Summary

The speaker presents an in-depth overview of Endoscopic Mucosal Resection (EMR), emphasizing its long history since the 1970s and its evolution with advancements like CAP-assisted EMR, band-assisted EMR, and ESD. EMR is foundational in endoscopic resection, effective for benign, flat, bumpy lesions with low cancer risk. The "perfect EMR," championed by expert Raju, involves a standardized approach: using adult colonoscopes, saline injections, snare resection, margin ablation (e.g., APC), clip closure, and scheduled follow-ups, achieving low recurrence (~4.5%).<br /><br />Key to success is careful lesion selection, procedural planning, and teamwork—particularly between the physician and the tech/nurse assistant—who anticipates instruments and manages delicate maneuvers like injection and snare control. The talk highlights the practical challenges of EMR, showcasing real cases including difficult polyps near the appendiceal orifice, and techniques such as tip-in EMR, piecemeal resection, and vessel management with hemostatic forceps. Proper closure using clips or suturing devices is crucial to prevent bleeding and complications.<br /><br />The speaker stresses that EMR saves patients from unnecessary surgery for benign polyps and underlines the critical role of the endoscopy team’s experience and collaboration in producing excellent patient outcomes. EMR remains indispensable even as new techniques like ESD and full-thickness resection develop.

Asset Subtitle

Phillip S. Ge, MD, FASGE

Keywords

Endoscopic Mucosal Resection

EMR history

CAP-assisted EMR

band-assisted EMR

ESD

benign lesion treatment

standardized EMR procedure

lesion selection

endoscopy team collaboration