Piecemeal EMR in 2026: Standardising Excellence
Where technique, recurrence and cost meet most sharply. Two meaty talks and a live resection, on the parts of large-lesion EMR that are no longer matters of opinion.
Running order (indicative)
- Head
- Prof David Tateanchors the studio throughout
- Talk 1
- Dr Lobke DesomerStandardising Optimal Piecemeal EMR
- Talk 2
- Dr Roland ValoriThe Case for a Dedicated EMR Service: Avoided Surgery, Costed
- Live case
- Dr Pieter Jan PoortmansDr Philippe LeclercqColonic LST for live EMR (piecemeal or en bloc) — technique & margin ablation
- Discussion
- Allremaining session time
The session, as written
Lecture 1 — Standardising optimal piecemeal EMR. The reproducible technique: complete snare excision, then thermal ablation of the margin — recurrence from ~20% to ~5% for the cost of a few extra minutes. What is standard, what is habit, and what the defect should look like before you leave.
Lecture 2 — The case for a dedicated EMR service: avoided surgery, costed. The business case with the surgical-mortality data quoted out loud: virtually no benign lesion should reach a surgeon without an attempted endoscopic resection first — conditional on quality, because by the third recurrence the patient should have had the hemicolectomy the first resection was meant to prevent. Avoided operations, avoided admissions and released capacity rather than raw revenue.
Live case — a colonic LST, resected. Injection, snare choice, margin ablation and defect assessment narrated — with a running tally of what this patient would otherwise have cost the system.
