- Colonoscopy is recommended for all adults at age 50 (with average risk) for routine colon cancer screening, during which a careful examination of the colon is performed to locate and remove polyps.
- Our practice is focused on therapeutic colonoscopy during which the endoscopist can perform a therapeutic intervention during the procedure. These interventions range from dilating a narrowing of the colon, to placement of a colonic stent to relieve a blockage of the colon or the removal of large polyps or early cancers using Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD) techniques.
EMR –Endoscopic Mucosal Resection
- EMR is a delicate technique that allows for the removal of lesions involving the mucosa or lining of the gastrointestinal tract. This technique is frequently used to remove large polyps in the colon but can also be used in the esophagus or stomach.
- During EMR, the mucosa is first lifted off of the wall of the gastrointestinal tract by carefully injecting fluid in the space between the mucosa and muscle layer. This creates a space in which the mucosa and associated lesion to be safely excised using a snare or metal loop that has electrocautery.
- In the hands of an Interventional Endoscopist, the majority of patients with large colon polyps can be treated adequately with Endoscopic Mucosal Resection avoiding the need for surgery.
ESD –Endoscopic Submucosal Dissection
- ESD is an intricate technique that allows for the removal of lesions involving the mucosa or lining of the gastrointestinal tract. This technique is used to remove early cancers that are limited to the lining of the esophagus and stomach and can also be used to remove large colon polyps.
- Similar to EMR, the mucosa is first lifted off of the wall of the gastrointestinal tract by carefully injecting fluid into the space between the mucosa and muscle layer. Expansion of this space allows for the safe dissection and removal of the mucosa and associated abnormal tissue using a specialized device called a needle knife.
- In the hands of an expert Interventional Endoscopist, ESD can be performed safely and potentially allow for curative resection of early cancers and very large colon polyps. This can also prevent the need for surgery.
EUS –Endoscopic Ultrasound
- EUS is an endoscopic procedure that combines standard endoscopy with ultrasound to obtain images of the different layers of the colon or rectum in addition to adjacent structures. EUS can be used to evaluate lesions that are underneath normal appearing lining in the colon or rectum or to stage cancers.
Benefits of Endoscopy
Allow patients to avoid invasive surgery
Most procedures are done in Outpatient Endoscopy Units
Patients can resume near normal activity within the same day
High safety profile
Why Choose IEA
Drs. Pitea and Mounzer have performed hundreds of colonic EMR cases over the last 4 years. They also have extensive expertise in colonic and rectal ESD.