Introduction: When it comes to endoscopic resection, ensuring complete lesion removal can be a challenge. However, the game-changer has arrived: The Hybrid ESD-EMR Technique. Klaus Mönkemüller sheds light on this advanced method designed for the complete resection of lesions in the colorectal, esophagus, and stomach areas.
Key Takeaways:
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Traditional Challenges:
- Conventional methods like endoic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) can be problematic. Especially with flat, slippery lesions, it's common to only capture a portion or experience slippage.
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The Solution – Hybrid ESD-EMR Technique:
- Often dubbed “precutting” EMR, it involves making a strategic incision around the lesion, setting the stage for a more effective snare placement.
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Step-by-Step:
- Create a submucosal cushion using injection.
- Use the snare tip to make a circumferential incision around the lesion.
- Achieve resection using EMR to complete the removal.
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Benefits:
- Enhances the R0 resection of the lesion's lateral aspect.
- If executed correctly, it secures a full vertical resection.
- It's versatile, effective on various lesion types like lipomas and tumors.
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Additional Tools:
- For harder-to-reach or less visible lesions, tools like the IT-knife can come into play, designed to reduce perforation risks.
Conclusion: The Hybrid ESD-EMR endoscopic resection technique marks a significant stride forward in the realm of endoscopy, promising a safer and more efficient method for healthcare professionals globally.
