Endoscopic Mucosal Resection (EMR) Snare Looping Technique
CAUTION: This guide only suggests a technique to set a snare when using the Olympus EMR Kit. Please review the Instruction Manual that was included with your Olympus EMR Kit purchase.
Snare Looping Technique
After you have injected the target area, you are ready to set the snare. Follow these tips to set the snare in the rim of the EMR cap:
1. Move the endoscope to an area away from the lesion to set your snare. Attempting to set the snare on the injected target area may cause your injection to leak or possibly damage your specimen. Once you have found a flat area of the mucosa, advance your scope so that the EMR cap is touching the mucosa.
2. Next, advance your snare catheter about 50% so that it is just in endoscopic view. Do not move your catheter once you have achieved this position. At this point, moving the catheter could prevent you from setting the snare accurately.
3. Now that your catheter is in place, apply a light suction. The goal here is to seal the open end of the cap with healthy, flat tissue, not to fill the cap with mucosa.
4. Once you have applied light suction, have your assistant fully open the snare wire. You will see the snare wire bounce 4 off the suctioned mucosa and fall into the rim of the cap
5. Once your snare wire is completely open, it is now time to adjust the snare catheter and wire. Maintain light suction and slowly start to push the catheter down towards the rim of the cap. Be sure not to push the catheter so far that it extends past the cap. While you are moving the catheter, have your assistant slowly start to close the snare wire. With slow, simultaneous movements, you and your assistant will be able to accurately set the snare in the rim of the cap. Once the snare is set, release your suction and return the endoscope back to the injected target area. Now it is time to fully suction the lesion. Once the lesion is fully suctioned inside the EMR cap, instruct your assistant to close the snare wire.
