What is EMR (Endoscopic Mucosal Resection)? Indications and Catheter Consumables Overview

1. Introduction to EMR Surgery
EMR (Endoscopic Mucosal Resection) is a minimally invasive gastrointestinal surgery primarily used for the treatment of early-stage gastrointestinal cancers and precancerous lesions. This procedure is performed using an endoscope, which eliminates the need for traditional open surgery. Patients benefit from faster recovery, and it is particularly suitable for treating small, localized lesions in the esophagus, stomach, and colon, especially early-stage cancer in these areas.

2. Indications
EMR is mainly used in the following cases:

1. Early-stage cancers: Such as early esophageal cancer, gastric cancer, and colorectal cancer, where the lesions are usually confined to the mucosal layer or the superficial submucosal layer, with no evidence of lymph node metastasis.

2. Precancerous lesions: Such as adenomas or high-grade intraepithelial neoplasia (HGIN), which have the potential to progress into malignant tumors.

3. Main Steps of EMR Surgery

1. Endoscopic examination and localization: The lesion is precisely located using the endoscopic system, and its size and shape are determined.

2. Injection step: Using an injection needle, saline or hyaluronic acid is injected beneath the lesion to separate the submucosa from the deeper tissues, causing the lesion to elevate and making it easier to remove.

3. Snare resection: A snare is used to encircle and remove the elevated lesion via electrosurgical currents. The snare can precisely capture and cut the target tissue.

4. Tissue retrieval and hemostasis: The excised tissue is retrieved through the endoscope, and any bleeding is managed as needed.

4. Main Catheter Consumables in EMR Surgery

1. Injection Needle Catheters

Function of the Injection Needle: The primary function of the injection needle is to inject fluid beneath the lesion, causing it to rise, thus facilitating its subsequent removal. By injecting saline or glycerin into the submucosal layer, the lesion is lifted from the base, creating a safe working plane and reducing the risk of injury to deeper tissues.

Design Features of Injection Needle Catheters:

o High-pressure injection capability: Injection needle catheters can inject fluids evenly under the lesion with high pressure, ensuring tissue elevation. The structure of the catheter can withstand high pressure to prevent fluid leakage.

o Flexible catheter material: Injection needle catheters are typically made from flexible materials, allowing them to easily pass through the endoscopic channel and navigate the complex curves of the gastrointestinal tract, making the procedure smoother.

2. Snare Catheters

Function of the Snare: The snare is used to accurately grasp and remove the elevated lesion. Through the use of electrosurgical currents, the snare effectively cuts the tissue and ensures complete resection, preventing any residual lesion.

Design Features of Snare Catheters:

o Catheter flexibility: Snare catheters are made from highly flexible materials, allowing for maneuverability within the endoscopic channel, particularly in the curved areas of the gastrointestinal tract. This catheter material ensures smooth operation and sufficient strength for precise cutting.

EMR is an effective and minimally invasive technique widely used for the resection of early gastrointestinal cancers and precancerous lesions. Injection needle catheters and snare catheters are the two most commonly used key consumables in EMR surgery, playing crucial roles in fluid injection and tissue removal. High-quality catheters not only enhance the success rate of the procedure but also reduce the occurrence of intraoperative complications. For physicians, choosing the right catheter consumables is essential to ensuring the smooth progress of the surgery.

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