Sedation practice for endoscopy varies widely in the United States. One model is to use anesthesia specialists to administer propofol for complex endoscopic procedures, such

Among 2629 large nonpedunculated colorectal polyps in 2350 patients, 10 were classified as anastomotic and had a median lesion size of 35 mm. All lesions

About 15% of large (≥20 mm) nonpedunculated colorectal polyps (LNPCPs) removed by piecemeal endoscopic mucosal resection (EMR) have evidence of recurrence at the first endoscopic

Those performing endoscopic mucosal resection (EMR) in the colorectum should be aware of this remarkably comprehensive document from the European Society of Gastrointestinal Endoscopy that

Endoscopic submucosal dissection (ESD) is an option for scarred, large colorectal adenomas that do not lift well and/or contain a suspicious area of an advanced

X-Tack (Apollo Endosurgery, Austin, Texas) is a through-the-scope suturing device that can be an alternative to through-the-scope clips. No controlled trial of X-Tack versus clips

Cold snare polypectomy is the accepted treatment of choice for all colorectal polyps smaller than 10 mm and with no suggestion of cancer on endoscopic

In an observational study of colorectal EMR, 67 of 336 patients (19.9%) experienced postprocedural pain. All EMRs were performed with electrocautery and adrenaline injection. Pain

Traditionally, even if careful inspection of an EMR scar at follow-up shows no residual polyp, a biopsy should still be performed to rule out histologic

Endoscopic mucosal resection (EMR) is the cornerstone of the treatment of large (≥20 mm) nonpedunculated colorectal lesions. This study from a Canadian expert center examined

Thermal treatment of endoscopic mucosal resection (EMR) margin defects after complete resection of large (≥20 mm) nonpedunculated colorectal polyps has reduced the recurrence rate at

Thermal treatment of the margin after piecemeal endoscopic mucosal resection (EMR) of laterally spreading lesions (LSLs) ≥20 mm is now considered standard of care because

Current strategies for the endoscopic treatment of Barrett’s esophagus (BE) focus on resection of nodular lesions within BE and then the ablation of the flat

We often hear that physician-identified large nonpedunculated colorectal polyps (LNPCPs) that warrant referral to an advanced endoscopist for endoscopic mucosal resection (EMR) or endoscopic submucosal

Tip-in endoscopic mucosal resection (EMR) involves submucosal injection, followed by an incision on the proximal side of the injection mound using a snare tip with

Thermal coagulation of the normal-appearing margin using snare tip soft coagulation (STSC) treatment after endoscopic mucosal resection (EMR) has been shown to reduce recurrence rates

Discussions of colorectal endoscopic mucosal resection (EMR) versus endoscopic submucosal dissection (ESD) usually focus on en bloc resection and recurrence rates. Little is known about

ORISE (Boston Scientific, Marlborough, Mass, USA) is a viscous gel for submucosal injection. When ORISE is used for endoscopic mucosal resection (EMR) or endoscopic submucosal

Traditionally, nonampullary small-bowel adenomas ≥10 mm in diameter are resected utilizing cautery. Unfortunately, since the small bowel is thin-walled and highly vascular, adverse events are

Recent large randomized controlled trials have demonstrated that clip closure reduces the risk of delayed hemorrhage after endoscopic mucosal resection (EMR) using electrocautery if the

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have emerged as important treatment techniques for patients with visible lesions in Barrett’s esophagus (BE). Whereas

Including epinephrine in the submucosal injectate for endoscopic mucosal resection (EMR) varies among endoscopists – some endoscopists prefer epinephrine, whereas others do not. Of those

One approach sometimes used in endoscopic mucosal resection (EMR) to improve complete resection is to use cautery to mark the normal tissue at the margins

Previous randomized controlled trials (RCTs) have indicated that prophylactic clip closure is effective in preventing delayed hemorrhage after EMR of colonic lesions that are ≥20

Patients with laterally spreading lesions and endoscopic evidence of T1 cancer (usually of morphologic change combined with NBI International Colorectal Endoscopic classification 3 or Kudo

Everyone performing EMR in the colorectum encounters flat or fibrotic polyp tissue that resists standard snaring.  In a multicenter European study, 70 nonlifting polyps with

In a 2019-2020 academic year survey of all 1730 GI fellows in the U.S. regarding endoscopic mucosal resection (EMR) training and knowledge, the response rate

Referring physicians sometimes tattoo large nonpedunculated lesions before referral, and resectionists sometimes tattoo the resection site for easy identification of the scar later. Neither practice

A previous randomized controlled trial showed that thermal ablation of a normal-appearing EMR margin after complete polyp resection reduced the recurrence rate from 21% to

Laterally spreading lesions (LSLs) of the duodenum are increasingly being diagnosed and treated endoscopically. Although endoscopic resection of the thin and vascular duodenal wall is

Clip closure of endoscopic mucosal resection (EMR) defects ≥20 mm located proximal to the splenic flexure and removed by electrocautery is associated with a reduction

Piecemeal endoscopic mucosal resection (EMR) of an extensive laterally spreading adenoma in the rectum

Randomized controlled trials demonstrate that prophylactic clip closure of endoscopic mucosal resection (EMR) defects of large (≥20 mm) nonpedunculated colorectal lesions effectively prevents delayed hemorrhage.

There is a well-known risk of adenoma recurrence after piecemeal endoscopic mucosal resection (EMR).  In a single-center study of 2411 nonpedunculated lesions ≥20 mm in

Recent studies indicate that prophylactic clip closure of postendoscopic mucosal resection defects from colonic lesions >20 mm in size and proximal to the splenic flexure

Given the paucity of high-quality outcome data, the optimal management of polypoid and/or nonpolypoid colonic lesions in IBD is an ongoing debate. Guidelines recommend that

Analyses of randomized trials indicate that prophylactic clipping of EMR sites ≥20 mm in size in the proximal colon reduces the risk of delayed hemorrhage.

Endoscopic submucosal dissection (ESD) is an effective method of resecting larger superficial esophageal lesions en bloc; however, it is fraught with advanced training needs, longer

Douglas K. Rex, MD, FASGE, reviewing Pohl H, et al. Gastroenterology 2020 Mar 12. Previous uncontrolled studies indicated that forced-coagulation (FC) current (the blue pedal)

Classification presented by Burgess NG et al. based on retrospective evaluation, clinical observations and image analysis. It allows for the assessment of deep mural injury

Douglas K. Rex, MD, FASGE, reviewing Mangira D, et al. Gastrointest Endosc 2020 Jan 15. In 5 Australian academic hospitals, cold EMR was performed on

Douglas K. Rex, MD, FASGE reviewing Tate DJ, et al. Gastrointest Endosc 2019 Dec 27. Advanced endoscopists are often tempted to remove laterally spreading lesions

EMR for an adenoma in the transverse colon ECN 2018

Endoskopische Mukosaresektion eines Rektumadenoms ECN 2018

Cold snare resection has been established in diminutive polyps (up to 5 mm) as being at least as safe and partially more effective than biopsy

Early esophageal carcinoma (squamous epithelium): tips and tricks for difficult ESDs

Arterial bleeding from the area of the endoscopic mucosal resection, 2 days after the intervention. Successful hemostasis is achieved using bipolar coagulation forceps in “Soft

Diagnosis of a granular-type laterally spreading tumor at the right colic flexure.