Surgery

Endoscopic Mucosal Resection (EMR) & Endoscopic Submucosal Dissection (ESD)

Why It’s Done (Indications) 

To remove very early-stage superficial cancers, large precancerous polyps, or flat growths in the digestive tract lining without needing open or keyhole surgery.

How to Prepare (Preparations)

• Medications: Inform your doctor about any blood thinners or diabetes medications, as they may need temporary adjustment.
• Bowel prep (for colon lesions) or fasting for 6 hrs before the procedure.
• Discontinuation of blood-thinning medications for several days as directed.
   

What Happens (Procedural Details)

1. Done under deep sedation or general anesthesia.
2. The doctor identifies the lesion using high-definition light and dye techniques.
3. A liquid solution (saline with dye) is injected directly underneath the lesion into the submucosal layer to raise it up like a cushion, separating it safely from deeper muscle walls.
4. EMR: A wire snare catches the lifted tissue and cuts it cleanly using electrical heat.
5. ESD: For larger or flatter tumors, tiny specialized electric knives are used through the scope to slice underneath the tumor in one single intact piece, allowing precise pathology testing.
    

Recovery (Postoperative Care)

• Requires overnight hospital stay for observation.
• Clear fluids for 24 hours, followed by soft foods for several days.
• Strenuous physical activity and heavy lifting should be avoided for 1 to 2 weeks.
   

Risks (Potential Complications)

• Bleeding from the resection site (may occur up to 2 weeks post-procedure).
• Perforation of the gastrointestinal wall (slightly higher risk with ESD, but often can be treated endoscopically with metal clips).
• Stricture (narrowing) of the esophagus or intestine during healing if a large area was removed.