A complete and safe EMR was done in a patient, who came from 5 hours away from our medical center, with multiple comorbid conditions. The patient has a long tortuous colon, with an unstable endoscope position using a combination of techniques for EMR - underwater EMR, injection to lift the lesion away from the underlying muscle, using different sized snares and keeping the cutting plane parallel to the wall. Subsequently, we closed the defect securely to minimize the risk of delayed complications.
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