Endoscopic Mucosal Resection
- 55 year old gentleman referred for removal of a lesion found at colonoscopy for a positive stool test.
- Lesions such as these are best managed in a centre with expertise in Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD)
- Whilst en-bloc resection is preferred, piecemeal resection is often necessary due to polyp size or location.
- In this case, the lesion lifted and resected well except at the biopsy site.
- The stuck down section had to be avulsed with forceps.
- The margin of the lesion was ablated to reduce the risk of residual polypoid tissue.
- Ablation techniques can include Argon plasma coagulation or thermal ablation.
- Regardless of the technique used to remove a large polyp, consideration is given to tattooing the site where the large polyp was removed to permit identification of the site during follow-up endoscopy or surgery.