Neil R. Sharma MD, has had additional specialized training in endoscopic resection, where he puts a tube down your throat to access your digestive tract to remove pre-cancerous or early-stage cancerous tissue that otherwise would require an external incision and removal by open, laparoscopic or robotic surgery.
His experience in performing endoscopic resection in a variety of techniques including Endoscopic Mucosal Resection- ”EMR” or Endoscopic Submucosal Dissection “ESD” has taught him about potential complications of the procedure.
Endoscopic Resection Procedures With Neil R. Sharma MD, Parkview Health
Dr. Sharma works with an anesthesiologist who has you sedated for endoscopic resection procedures, so you’ll feel no pain while the endoscope is placed and the abnormal tissue removed. Due to more nerves being on the skin, and this surgery occurring through the scope from “the inside out,” recovery should be quicker and less painful as well.
The standard outpatient EMR procedure has six basic steps.
- First, your doctor will insert the endoscope and move it to the abnormal tissue, marking a line around it where the incision will be made
- Next, specialized fluid will be injected under the tissue, elevating the abnormal tissue away from the healthy tissue, so the healthy tissue isn’t cut into.
- Then your doctor will lift the abnormal tissue, often using gentle suction through the endoscope tube.
- After that, the abnormal tissue will be cut out, separating it completely from the healthy tissue in one piece.
- Following this, the doctor will use an endoscopic basket — a fine mesh bag — to remove the abnormal tissue.
- Finally, in some cases, your doctor will close the internal defect with clips, endoscopic suturing or other techniques if needed depending upon size, location, and if you use blood thinner medications.
Four Common Complications of EMR
Neil R. Sharma MD, says that there are four common complications of the EMR procedure, as there are with any surgical procedure, both inpatient and outpatient.
- Infection — It’s possible during any surgical procedure for bacteria to enter the surgical site or blood stream. Symptoms may include fever, chills, and vomiting. Depending on the severity of the infection, you may be hospitalized to receive IV antibiotics or prescribed antibiotics to take at home.
- Esophageal narrowing — If the lesion that was removed encircled your esophagus, there may be scarring that causes the esophagus to narrow. Symptoms include trouble swallowing. Further endoscopic treatment may be necessary to remove the scar tissue.
- Bleeding at the surgical site — This is usually found during the procedure and dealt with at that time. However, it’s also possible that your doctor may miss seeing it. Symptoms may include blood in your stool or vomiting blood. If you experience these symptoms, contact your doctor right away.
- Perforation of the digestive tract — Depending on where the abnormal tissue is located, it’s possible that your doctor may puncture through the wall of your digestive tract. In some cases this occurs intentionally because it is required to remove the lesion when it is deeply tethered to the wall. If it is done inadvertently because the anatomy is challenging or the lesion grows into deep layers of the wall of an organ, it must be treated. If recognized during the procedure, it can be treated endoscopically and often may require just some additional antibiotics and/pr conservative care. Sometime during the healing process or because of other stress to the surgical site, a perforation can occur after the patient leaves and goes home. In those cases symptoms include dizziness, abdominal pain, fever, abdominal swelling. The patient should come back to the ER immediately for medical attention.
After the procedure, it may take some time for you to wake up from your sedation. You may experience mild side effects, including a sore throat, drowsiness, nausea, vomiting, bloating, and gas.
All surgical procedures carry risks. Neil R. Sharma MD, wants to make sure you know the potential complications of an endoscopic resection, so you can be prepared ahead of time in case one happens to you.