What is EMR?
Endoscopic Mucosal Resection, or EMR, is a minimally invasive procedure used to remove early-stage cancers or large precancerous polyps from the lining of the digestive tract.
The procedure involves injecting a special fluid beneath the abnormal tissue to lift it up, creating a cushion that separates the lesion from the deeper layers of the wall. A specialised wire loop, called a snare, is then passed through the endoscope to cut and remove the lifted tissue safely.
EMR is performed during an endoscopy or colonoscopy and can allow doctors to remove selected concerning growths without the need for major surgery.
Remove selected lesions without major surgery
Your specialist will consider the size, location, depth, appearance and other features of the lesion before deciding whether EMR is appropriate.
Large Colorectal Polyps
EMR may be used to remove large, flat or sessile colorectal polyps that are not suitable for standard snare polypectomy.
Early-Stage Cancers
Selected early esophageal, gastric or duodenal cancers confined to the mucosa may be treated endoscopically with EMR.
Dysplastic Tissue
EMR can remove abnormal or dysplastic tissue that may carry a risk of progressing to cancer.
Barrett’s Esophagus
EMR may be used to remove visible abnormal tissue in selected patients with Barrett’s esophagus and high-grade dysplasia.
Complete Tissue Sampling
The removed tissue can be sent for pathological analysis to support accurate diagnosis, assessment of margins and staging.
Avoid Major Surgery
When a growth is confined to the superficial layers, EMR may offer a less invasive alternative to conventional surgery.
What happens during the procedure?
EMR uses a controlled lift-and-resect technique. The lesion is separated from deeper tissue before it is captured and removed with a snare.
Sedation & Endoscopy
You will receive intravenous sedation and be asleep or deeply relaxed while the endoscope or colonoscope is advanced to the abnormal tissue.
Submucosal Injection
A special solution is injected beneath the lesion to lift it away from the deeper muscle layers.
Creating a Safety Cushion
The lift creates a cushion between the lesion and deeper wall, helping reduce the risk of injury during removal.
Snare Placement
A specialised wire snare is passed through the endoscope and positioned around the lifted tissue.
Controlled Resection
The snare is gently tightened and controlled electrical current is used to cut the tissue free.
Specimen Retrieval
The removed tissue is retrieved through the endoscope and sent to the laboratory for pathological analysis.
Duration depends on the size and number of lesions
EMR often adds approximately 15–30 minutes to an endoscopy or colonoscopy, although the actual duration varies depending on the size, location, number and technical complexity of the lesions.
What should you expect after EMR?
You will be monitored in recovery after the resection and given specific instructions based on the location and size of the treatment area.
Recovery from Sedation
You may feel groggy for a short period after waking up in the recovery area.
Mild Discomfort or Bloating
Mild abdominal discomfort, gas or bloating may occur and usually improves quickly.
Liquid or Soft Diet
A liquid or soft diet may be advised for the first 24 hours, or as directed by your doctor, to support healing.
Observation
Many patients can go home after several hours of observation, although an overnight stay may be recommended in selected cases.
Blood Thinners & Exercise
If a large lesion was removed, your doctor may advise temporary restrictions on blood-thinning medication and strenuous activity.
Pathology Results
The removed tissue is sent to pathology. Results often take about 5–10 days, although timing can vary by laboratory and the type of analysis required.
Important precautions before and after EMR
Inform your doctor about all medications, especially blood thinners or antiplatelet medicines, and do not stop them unless instructed. Follow fasting and preparation instructions carefully. Seek urgent medical attention if you develop severe or worsening abdominal pain, fever, vomiting blood, significant bleeding, black or heavily blood-stained stool, dizziness, breathing difficulty or other concerning symptoms after the procedure.
EMR is an established minimally invasive treatment for selected early lesions
EMR is a safe, effective and well-established endoscopic option for removing selected early cancers, precancerous tissue and large polyps from the digestive tract. It can provide both treatment and a complete tissue specimen for pathological assessment. In appropriately selected patients and when performed by experienced endoscopists, EMR may avoid or reduce the need for major surgery and support a shorter recovery.