Depending on the size, location and complexity of the polyp, the endoscopist may opt for a classic polyp resection with snare, for endoscopic submucosal dissection (ESD) or for piecemeal endoscopic mucosal resection (EMR).

The choice for ESD or EMR is always taken in consultation with your attending physician and after considering many factors.

Endoscopic mucosal resection (EMR)

Another option for the removal of large polyps is endoscopic mucosal resection (EMR). For this procedure too, fluid is injected in between the polyp and the underlying muscle layer to allow for the safe capture of the polyp with a snare. The polyp is cut through completely and, depending on the size, this can be done in pieces, a so-called ‘piecemeal EMR’. The final result is, of course, that no remaining polyp tissue can be seen.

The big advantage of this procedure is that the removal of the polyp is clearly faster than with ESD and carries less risk of complications. However, compared to ESD, the polyp will usually have to be analysed in separate pieces, which may be more complicated for the pathologist. Additionally, the risk is higher that microscopically small parts of the polyp remain in place that will then grow back.

Centres and specialist areas

Digestive Centre

Latest publication date: 05/02/2021
Supervising author: Dr Vanderstraeten Erik