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What is EMR of Polyps?

EMR is a minimally-invasive procedure to remove polyps from the wall of the gastrointestinal tract. The digestive tract or the gastrointestinal (GI) tract is a series of hollow organs including the mouth, pharynx, oesophagus, stomach, small intestine, large intestine and the anus.

Most GI cancers begin as a mass of abnormal cells called a polyp. Untreated polyps can become cancerous and spread to nearby tissues, lymph nodes or distant organs, disrupting their function. EMR involves the use of an endoscope to remove a polyp without the need for major surgery. An endoscope is a long, thin, flexible tube with a tiny video camera and light at the end. Images from the camera are transmitted to a large monitor for your physician to view the inside of your GI tract.

What are the Indications of EMR?

EMR is commonly indicated for the removal of oesophageal or colon polyps. In the case of polyps that have become cancerous, EMR can help diagnose the extent of cancer progression.

Preparing for EMR

  • Your doctor will assess your symptoms and take a medical history.
  • Talk to your doctor about the medicines you are taking prior to the procedure.
  • Inform your doctor if you are allergic to any medication or anaesthesia.
  • You may be prescribed laxatives or enemas to cleanse your bowel a day before the procedure,
  • Do not eat or drink for at least 8-10 hours before the procedure.
  • Arrange for someone to drive you home after the procedure.

How is EMR Performed?

A gastroenterologist trained in EMR performs the procedure that involves the following steps:

  • An IV line is started in your arm to administer anaesthesia to make you sleep.
  • Your vital signs such as heartbeat, blood pressure and respiratory function will be monitored.
  • An endoscope is inserted through your mouth and advanced towards the oesophagal polyp. For rectal or colon polyps, an endoscope will be inserted through the anus.
  • The images of the polyp are observed on a monitor.
  • A thin wire is inserted through the endoscope and advanced towards the base of the polyp to lift it away from the surrounding tissue.
  • Small electric current is used to cut the polyp at its base and the wound is closed to prevent bleeding.
  • Specialised tools are used to remove the polyp outside your body through the endoscope.

After the Procedure

You will need to spend a few hours in the recovery room under observation while the anaesthesia wears off. Your doctor will discuss the results of your procedure either on the same day after your procedure or during your follow-up. You may experience a sore throat if the scope was passed through the mouth or minor cramps. You are advised to rest for a day or two before getting back to normal activities.

When to Call a Doctor?

Call your doctor if you experience symptoms such as:

  • Fever and chills
  • Blood in the stools
  • Nausea and vomiting
  • Abdominal pain
  • Shortness of breath

What are the Advantages of EMR?

The advantages include:

  • No need for an incision
  • Outpatient procedure
  • Minimal pain
  • Short recovery time
  • Preserves normal gut function

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