EMR切除扁平结肠息肉与息肉切除术瘢痕

                               
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Video highlights of a flat colon tubular adenoma referred for EMR resection but complicated by a previous incomplete resection attempt causing scarring of the distal margin of the lesion not allowing submucosal lift in this area.

00:11 - Evidence of scar from polypectomy attempt on distal margin
00:22 - Submucosal lift (Eleview) is nicely shown in the proximal aspect of the lesion
00:45 - However submucosal injection in the proximal aspect is hindered by scarring due to prior polypectomy site
00:57 - Snare resection using a large stiff snare (Captivator II 33mm) was not successful due to non-lifting
01:14 - Decision was made to use Cap EMR-Ligation (Duette) to perform piecemeal resection of the lesion
05:08 - Scarred site however could not be banded due to fixation
05:25 - Therefore a direct cap suction+snare technique without banding was used to ensnare the fixed mucosa for successful resection of this area
06:24 - Complete resection was followed up with APC of the borders (not shown in this video)
06:35 - Original submucosal injection of Eleview (00:23) still present even after 37 minutes after injection