EMR (Endoscopic Mucosal Resection)

EMR, Endoscopic Mucosal Resection, is the endoscopic removal of lesions such as large polyps or superficial tumors in the esophagus, stomach or intestines. This technique is generally preferred for the removal of lesions that are risky to cut out directly. The thickness of the stomach wall is about 5 mm, while the intestinal wall is about 2-3 mm thick. Therefore, endoscopic removal of lesions larger than 5 mm and especially larger than 10 mm carries the risk of bleeding and perforation.

To minimize these risks, we use the EMR method. In this method, a special fluid is injected into the base of the lesion. This fluid increases the wall thickness, creating a “cushion” between the normal tissue and the lesion. A wire is then laid around the lesion and the lesion is cut out using electric current. This approach significantly reduces the risks of bleeding and perforation.

How is EMR Applied?

Endoscopic mucosal resection is performed with a long, narrow tube equipped with a light, video camera and other instruments. During EMR of the upper digestive tract, the tube (endoscope) is passed through the patient’s throat to reach an abnormality in the esophagus, stomach or small intestine (duodenum).

To remove lesions from the colon, the tube is guided through the anus.

Primarily a treatment procedure, EMR is also used to collect tissue for diagnosis. If cancer is present, EMR can help determine if the cancer has invaded the tissues under the lining of the digestive tract.

Endoscopic mucosal resection is usually performed by a specialist in diseases of the digestive system (gastroenterologist) who is an expert in this technique.

How long is the hospital stay?

Patients undergoing EMR are discharged approximately half an hour after the anesthetic effect wears off.

Is EMR a risky procedure? What are the possible risks? In which cases should a doctor be consulted after the procedure?

EMR is a very safe procedure if performed in experienced hands. Possible risks include bleeding or very rarely perforation. It is therefore vital that the physician performing the procedure is experienced in this area. In case of bleeding or severe pain after the procedure, a doctor should be consulted.

What should the patient pay attention to after the procedure?

If the EMR procedure was performed in the esophagus or stomach, it is generally recommended to consume liquid or liquid foods that day and to avoid very hot drinks. If larger lesions are removed, this liquid diet may be extended to several days. All detailed information and recommendations are given to the patient by the doctor.