EMR

What is an EMR?
Endoscopic mucosal resection (EMR) is an advanced endoscopic procedure that is used to remove cancerous or other abnormal tissue from the gastrointestinal (GI) tract in a minimally invasive fashion.  This technique is a less invasive alternative to surgery for removal of certain types of early stage cancers and pre-cancerous lesions of the digestive tract.  This includes lesions located in the esophagus, stomach, duodenum, colon, and rectum.  EMR is only performed by a specialist in the field of gastroenterology with expertise in this technique.

What should I expect during an EMR?
For EMR of the upper GI tract, you will be asked to fast for at least 6 hours before the procedure.  For EMR involving the lower GI tract, you will be asked to either take a colonic cleansing solution or take laxatives and enemas prior to the procedure.  Expect to spend 2 - 3 hours at the hospital the day of your EMR. The procedure itself takes approximately 30 to 90 minutes to complete. Before the procedure a nurse will insert an intravenous (IV) line into your hand or arm. During the procedure, an anesthesiologist or CRNA will provide medications to ensure that you are sedated and comfortable. The physician will insert a flexible, lighted endoscope into your mouth or anus and will advance it to the area of interest.  A sterile fluid will be injected under the lesion to lift it and create a cushion between the lesion and the healthy tissue underneath it.  The lesion will then be resected, or “cut” out, from the surrounding healthy tissue.  This can be accomplished with a variety of techniques and will vary depending on the EMR site.  The area may then be marked with ink (tattoo) in order to identify it for future endoscopic exams.

What should I expect after an EMR?
The physician will discuss the results of the procedure with you, as well as a family member if you choose.  You will also be given a written report and post procedure instructions.  Some patients experience mild bloating, cramping, and/or a sore throat after the procedure.  These symptoms are typically mild and resolve with time.  Any tissue removed during the procedure will be sent to a lab for evaluation. You will be contacted by phone or mail with the results in 1 – 2 weeks.

You may resume most of your regular activities the day after the procedure. Due to the medications given during the procedure DO NOT drive on the day of your procedure.  You will receive specific instructions from your doctor regarding when you can resume a diet.  Alcohol should be avoided until the next day after your procedure.