Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)

Figure 1

(a, b) SNADETs are likely to cause fibrosis by biopsy, making it difficult to obtain good lifting by submucosal injection. In addition, the injected fluid tends to spread horizontally due to the coarse submucosal layer which makes snaring more difficult. (c, d) Water immersion decreased the luminal extension force and increased mucosal and submucosal buoyancy, which facilitates their snaring.

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