UPPER GI EMR
Endoscopic mucosal resection (EMR) for the Upper GI tract is defined as the use of various snares, cautery and injection/lifting technique in the resectionof large mucosal lesions of the stomach and small bowel (non-ampullary).
Skills to be covered
- Lesion Recognition
- Submucosal Injection Techniques
- Piecemeal Resection of Flat Lesions
- Band Ligator and Cap Assisted Lesion Resection
- Clipping/EMR closure
- Perforation Management
- Communication Skills
The enrollment criteria described below is intended to give potential participants an idea of the basic skill levels expected of program participants, and the skills that are needed to successfully perform upper EMR. Enrollees should have:
- Successful completion of both the knowledge and skills assessments of the Lower EMR STAR Certificate Program is a prerequisite for enrollment in the Upper EMR STAR Certificate Program.
- Enrollees are expected to be proficient in band ligation, hemostasis, use of clips, and saline-lift polypectomy
Note: Upper EMR should be performed in a multidisciplinary setting with access to EUS
and surgical oncology. Access to these services should be considered prior to pursuing
performance of upper EMR.
After attending this program, participants should be able to:
- 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 techniques in the endoscopic mucosal resection (including Cap and Band ligator assisted EMR) of these lesions.
- Demonstrate the use of appropriate accessories for management of complications
- Select appropriate surveillance intervals based on current guidelines