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What Is an Endoscopic Mucosal Resection?

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  • Written By: Jillian O Keeffe
  • Edited By: Shereen Skola
  • Last Modified Date: 21 November 2016
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The mucosa is the type of tissue that lines the inside of the digestive tract in the human body. When a procedure is endoscopic, it means that it involves the use of a long, thin tube with an attached camera and light, which the doctor inserts into the body. Resection describes a procedure that removes part of a bodily tissue, such as a lump on the mucosa. An endoscopic mucosal resection, therefore, describes any procedure that uses an endoscope to remove a part of the mucosa, such removing a polyp from the large intestine. Commonly, this type of procedure is used to diagnose illness and to surgically remove abnormal tissue from the digestive tract.

As a lining for the digestive tract, which runs from the mouth down to the anus, the mucosa have to perform several jobs. It acts as a first line of defense against infections from the outside environment such as bacteria or parasites. In addition, it must be strong enough to remain intact despite the passage of food, drinks and fluids like stomach acid, but it also has to be flexible enough to allow these things to pass through the body efficiently. The mucosa has to also be able to absorb nutrients and water into the body. Although in most people the mucosa does not produce much, or any medical problems over time, sometimes this multipurpose lining develops localized problems.

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Excessive growth of certain areas of the mucosa, such as polyps in the intestine, can be problematic for some people, but may also produce no symptoms. These lumps of mucosal tissue may be harmless overgrowths, or they may be cancerous. Doctors often wish to investigate the presence of growths on the mucosa in more detail, in order to rule out cancer. If the lump is causing problems for the patient, such as in swallowing or going to the toilet, then the technique is useful for removing the lump, whether it is otherwise harmless or not.

An endoscopic mucosal resection is one of the ways a doctor can do this. Less invasive than an operation, the endoscopic mucosal resection does not require the patient to have an incision made in his or her body. Instead, the doctor inserts the endoscope tube into a natural orifice, such as the mouth, and then moves the tube further into the body until it reaches the area involved. The tube has a camera and a light, so the doctor can see the problem area, and it also has another tool that can remove the abnormal cells.

When the end of the tube reaches the abnormal tissue, the doctor performing the endoscopic mucosal resection can then remove the abnormal cells. An example of the tool that attaches onto the endoscopic tube is a loop, which the doctor places over a lump and then tightens until the abnormal cells fall off the mucosa. Normally, the attachment also contains a cauterizing tool, which burns the resulting wound to prevent blood loss. Often, a patient does not require general anesthetic while undergoing endoscopic mucosal resection and can go home after the procedure instead of staying in hospital overnight.

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