Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) Periprocedural Care

Updated: Dec 13, 2019
  • Author: Raymond E Kim, MD; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care

Equipment

Tools specific to endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are discussed in more detail elsewhere (see Technique). Additional equipment includes the following:

  • Retrieval net or basket for specimen retrieval
  • Injection needle and injection fluid for lifting
  • Hemostatic clips and hemostatic forceps for control of bleeding and repair of small perforations

Specimens should be labeled according to their location (particularly within the esophagus and stomach), spread and pinned at the periphery of the specimen to a backing, and stored in formalin solution.

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Patient Preparation

As a rule, EMR and ESD can be safely performed with procedural sedation. Appropriate consideration should be given to cardiopulmonary comorbidities and anesthesia support.

The procedure is generally performed with the patient in the left lateral decubitus position.

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