Endoscopic mucosal resection (EMR)

Endoscopic mucosal resection (EMR) is an advanced endoscopic technique that makes it possible to remove large superficial lesions from the lining of the digestive tract. Unlike standard polypectomy, EMR is suited to flat or sessile lesions larger than 20 mm, laterally spreading adenomas and superficial cancers that do not extend beyond the submucosa. The technique is based on injecting a solution into the submucosa (submucosal cushion) in order to lift the lesion and separate it from the deep layers of the digestive wall. This lifting allows a safer resection by reducing the risk of perforation and making it easier to capture the lesion with the diathermy snare. The resection can be performed in a single piece (en bloc) or in several fragments (piecemeal) depending on the size of the lesion. Histological analysis of the resected specimens is fundamental: it confirms the nature of the lesion, assesses the resection margins and determines whether the endoscopic treatment is sufficient or whether additional surgical management is necessary. EMR thus makes it possible to avoid major surgery in many patients. At Clinique Pasteur in Tunis, EMR procedures are performed by endoscopists experienced in advanced resection techniques. The procedure takes place under general anesthesia in a safe environment, with close follow-up to prevent complications.