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Related Experiment Videos

Endoscopic mucosal resection using a cap: techniques for use and preventing perforation.

H Inoue1, T Kawano, M Tani

  • 1First Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan. hiro.inoue.srg1@med.tmd.ac.jp

Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie
|August 28, 1999
PubMed
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Endoscopic mucosal resection with a cap (EMRC) allows gastrointestinal lesion removal. Large volume submucosal saline injection is recommended to reduce perforation risk during EMRC procedures.

Area of Science:

  • Gastroenterology
  • Endoscopic Surgery

Background:

  • Endoscopic mucosal resection (EMR) is a local treatment for gastrointestinal lesions, yielding specimens for histopathology.
  • The transparent plastic cap-assisted endoscopic mucosal resection (EMRC) technique was developed in 1992 for accessing diverse gastrointestinal mucosa.

Observation:

  • EMRC has been performed in 380 cases of gastrointestinal lesions.
  • Perforation is the most serious complication, with two cases (esophagus and colon) reported.
  • Video analysis identified inadequate submucosal saline injection as a primary cause of perforation.

Findings:

  • Large volume submucosal saline injection is recommended to create a larger bleb, potentially reducing perforation risk.
  • Target mucosa should be resected at the middle of the bleb, not the base.

Related Experiment Videos

  • Sufficient saline volume and controlled suction are crucial, especially in the colon due to larger cap size.

    • Implications:

    • Optimized EMRC technique can enhance patient safety by minimizing perforation risks.
    • The findings provide technical guidance for endoscopists performing EMRC, particularly in challenging locations like the colon.
    • Standardizing submucosal injection and suction control can improve outcomes for endoscopic resection procedures.