Colonoscopy - Ascending Colon EMR - Large Flat Lesion

A case of a middle aged woman was referred for EMR of a large flat lesion in ascending colon..

The procedure was started with total intravenous anesthesia; after noticing respiratory movements, the endotracheal tube was placed to allow controlled breathing.

The lesion required rotation of the patient to allow the lesion to come to a better position for resection. During the procedure, water jet was used to control the bleeding while APC probe was inserted to avoid flooding of the field with blood as the lesion was in a dependent position. Before finishing, an APC of the edge and a clip closure were performed.