Related Experiment Video
Updated: May 24, 2026
A New Ex Vivo Model for the Evaluation of Endoscopic Submucosal Injection Material Performance
Published on: October 19, 2018
Endoscopic mucosal resection with an over-the-counter hyaluronate preparation
Shai Friedland1, Shivangi Kothari, Ann Chen
1Department of Gastroenterology, Veterans Administration Palo Alto Health Care System, Palo Alto, California, USA. shai_friedland@yahoo.com
Background:
Hyaluronic acid (HA) provides a long-lasting and distinct mucosal elevation for EMR, but expense and inconvenience have limited its adoption.
Objective:
To evaluate the safety and efficacy of an over-the-counter 0.15% HA preparation for EMR.
Design:
Retrospective study.
Setting:
Veterans Administration Hospital and university hospital.
Patients:
30 patients with a total of 32 colonic lesions and 1 duodenal lesion.
Intervention:
EMR by using HA.
Main Outcome Measurements:
En bloc resection rate and complications.
Results:
EMR was successful in all cases. En bloc resection was achieved in 26 of the 28 lesions up to 25 mm in diameter. Two lesions, both with fibrosis from prior attempted resection, had trace residual tissue necessitating cauterization with argon plasma. Five lesions measuring 30 mm to 60 mm all required piecemeal resection. There was one complication, a postpolypectomy bleed.
Limitations:
Small number of patients and retrospective design.
Conclusions:
EMR may be performed safely and effectively by using an inexpensive, over-the-counter 0.15% HA preparation. Further studies are needed to verify the results of this study and to compare the safety and efficacy of this HA preparation with saline solution.
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