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EDUCATION

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Objectives

 

Lower GI EMR Module 

Upper GI EMR Module 

 

 

 

Definition

Endoscopic mucosal resection (EMR) for the Lower GI tract is defined as the use of various snares, cautery and injection / lifting technique in the resection of large, complex or high risk colonic polyps.

 

Endoscopic mucosal resection (EMR) for the Upper GI tract is defined as the use of various snares, cautery and injection / lifting technique in the resection of large mucosal lesions of the stomach and small bowel (non-ampullary).

Enrollment Criteria

 

  • A minimum of two years in practice post-fellowship
  • Performed at least 500 colonoscopies independently, and currently performing colonoscopy as part of daily practice
  • Proficiency in basic polypectomy, hemostasis, and injection techniques
 
  • Successful completion of both the knowledge and skills assessments of the Lower EMR STAR Certificate Program.
  • Enrollees are expected to be proficient in band ligation, hemostasis, use of clips, and saline-lift polypectomy
 

Learning Objectives 

 

Describe the morphology of colonic polyps and assess their endoscopic appearance for resectability

Describe the morphology of large or complex mucosal lesions of the Stomach and small bowel (excluding Barrett's and ampullary lesions) and assess their endoscopic appearance for resectability

 

Appropriately select and demonstrate the use of various snares, cautery and injection/lifting technique in the endoscopic mucosal resection of "large, complex or high risk" colonic polyps ( e.g., > 20 mm, difficult location, with depression or significant nodularity) .

Appropriately select and demonstrate the use of various techniques in the endoscopic mucosal resection (including Cap and Band ligator assisted EMR) of these lesions

 

Demonstrate the use of appropriate accessories for both polyp retrieval and management of complications

Demonstrate the use of appropriate accessories for management of complications

 

Select appropriate surveillance intervals based on current guidelines

Select appropriate surveillance intervals based on current guidelines

 

 

 

Skills to be covered

Lower GI

Upper GI

Band Ligator and Cap Assisted Lesion Resection

 

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Clipping/EMR Closure

 

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Communication Skills

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Complication Management

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Lesion Recognition

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Perforation Management

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Piecemeal and Snare Resection

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Piecemeal Resection of Flat Lesions

 

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Polyp Retrieval

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Polypectomy Site Treatment

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Submucosal Injection Techniques

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Tattooing

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