Endoscopic mucosal resectionSchematic diagrams illustrating endoscopic mucosal resection (EMR) techniques. A, The "Strip Biopsy technique" Using a single channel scope, saline is injected at the base to raise the lesion. A snare is placed at the base and the lesion resected using the standard electrosurgical technique. B, The "Lift and Cut technique": Using a dual channel scope, saline is injected at the base to raise the lesion. The lesion is then grasped with a "rat tooth" forceps, and advanced through an open snare. The snare is placed at the base, which is then transected using standard electrosurgical technique (lift and cut). C, The "Cap technique": The lesion is first raised by saline injection, and is then suctioned into a cap fitted to the tip of the endoscope. The lesion is then resected using a pre-looped snare at the tip of the cap. (Adapted from Waxman I, Saitoh Y. Gastrointestinal Endoscopy 52(3): 322-7, 2000; with permission.)
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