Endoscopic mucosal resection for pediatric endoscopists: technical principles, practical considerations, and lessons from adult practice (with video)

Abstract

Abstract Purpose Pediatric endoscopic mucosal resection (EMR) remains uncommon outside specialized centers, and pediatric-specific educational resources and procedural training opportunities are limited. This video-based educational article demonstrates core EMR principles while emphasizing practical considerations for their application in pediatric therapeutic endoscopy. Methods Representative adult EMR cases were selected to illustrate fundamental technical principles relevant to pediatric therapeutic endoscopy, including en bloc and piecemeal conventional hot snare EMR. The accompanying video demonstrates lesion assessment, submucosal injection, cap-assisted visualization, snare selection, electrosurgical technique, thermal margin ablation, and defect closure. Throughout the narration, pediatric-specific guidance is integrated regarding equipment selection, patient selection, procedural safety, technical limitations, and referral to experienced pediatric advanced endoscopy centers. Results The video demonstrates conventional EMR, including lesion characterization, submucosal lifting, en bloc and piecemeal resection, thermal margin ablation, defect closure, and practical pediatric-specific technical considerations. Conclusion This video-based educational article provides a practical overview of conventional EMR principles and demonstrates how established EMR techniques may be thoughtfully adapted to pediatric therapeutic endoscopy.