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Underwater Endoscopic Mucosal Resection

Resection is performed under water submersion with a stiff, braided snare. The opened snare is positioned fully around the marked lesion margins and pushed against the bowel wall to displace the adenoma-bearing mucosa through the open snare. The snare is adjusted by a to-and-fro movement and torqued along with gentle water suction (a water filled lumen does not rapidly collapse) to crimp the lesion along with a normal rim of surrounding mucosa. With the lesion fully entrapped, continuous, steady closing pressure is applied to the snare along with uninterrupted current. A blended current is typically applied while pure cut current is preferred in areas of decreased bowel wall thickness or heavy scarring. Water is infused continuously during current application to enhance any heat sink effect. Please enjoy this promotional video by contributors to Advanced Techniques for Endoscopic Resection in the GI Tract, edited by Peter V. Draganov, MD ; Takuji Gotoda , MD, PhD; and Dennis J Yang, MD Click here to find out more about this book: https://www.healio.com/books/gastroen... This video represents one of the expert topics covered within this new text. In recent years, there have been major strides in safety and efficacy of minimally invasive endoscopic approaches with ongoing advances in therapeutic endoscopy. Advanced Techniques for Endoscopic Resection in the GI Tract provides an in-depth analysis of the current state of advanced endoscopic techniques for evaluation and resection, ideal for interventional GI endoscopists and general gastroenterologists, as well as surgeons. Each chapter in the book addresses specific topics such as: endoscopic evaluation of lesions, technical aspects of the procedure, management of adverse events, and post-procedural care and follow-up.