Endoscopic Mucosal Resection (EMR)
EMR is a specialsied form of Polypectomy that allows the Gastroenterologist to remove large flat or sessile polyps during colonoscopy, whereas in the past these polyps would have required surgery. Using this technique, polyps of almost any size can be removed, so long as they have not yet turned cancerous. Dr Prematilake can generally be able decide this through careful inspection of the polyp.
The technique of EMR involves the injection of a specialised solution* into the bowel wall (submucosa) just below where the polyp is attached. This lifts the polyp up off the bowel wall on a cushion and means the polyp can be safely snared off either in one or many pieces, until it has been completely removed. The solution is made up of a volume expanding type of intravenous fluid (Gelofusine mixed with blue dye to highlight the polyp tissue (methylene blue)) and a tiny amount of adrenaline to prevent bleeding.
Colonoscopy with EMR carries a slightly higher risk than normal procedures with around a 0.5% chance of bowel perforation and 5-10% chance of post procedure bleeding. A small number of those polyps can recur.
Dr Prematilake performs EMR procedures in public and private hospitals and in almost all cases the patient is able to go home on the same day like a normal colonoscopy. I will ask you to stay on a clear liquid diet overnight following the procedure and to contact me if there are any problems. If I am worried I admit overnight for observation.