The Hybrid ESD-EMR Technique Explained

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.

EMR technique

Key Takeaways:

  • 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.
  • 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.
  • 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.
  • 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.
  • 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.

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