Two-endoscope technique of endoscopic mucosal resection and kit with a set of endoscopes for the method

A method for endoscopic mucosal resection (EMR) using a kit comprising a first and a second endoscope, the method comprising:

• moving the first endoscope with an open distal end and a first biopsy channel toward a mucosa in a region of a lesion;
• deploying a spray cannula through the first biopsy channel of the first endoscope;
• performing chromoendoscopy by spraying, through the spray cannula, a liquid staining dye on a mucosa around the lesion and on a mucosa of the lesion to stain the lesion;
• washing the mucosa in the region of the lesion to remove a stain of the liquid staining dye from the mucosa around the lesion, while a persistently stained area of the mucosa of the lesion remains after the washing of the mucosa in the region of the lesion;
• passing an injection needle through the first biopsy channel of the first endoscope, inserting the injection needle through the persistently stained area of the mucosa of the lesion into a submucosa, which supports the mucosa of the lesion, and injecting a liquid, by the injection needle, into the submucosa to elevate the persistently stained area of the mucosa of the lesion in a region of the injection of the liquid to form an elevated mucosa of the lesion;
• then withdrawing the first endoscope;
• moving the second endoscope, which has a second biopsy channel and is pre-fitted with an end cap at a distal end of the second endoscope, toward the persistently stained area of the mucosa of the lesion;
• sucking, by the second biopsy channel of the second endoscope and by the end cap, the persistently stained area of the mucosa of the lesion along with the injected liquid into the end cap of the second endoscope and applying sufficient suction on the persistently stained area of the mucosa of the lesion to draw the persistently stained area of the mucosa of the lesion into the end cap;
• deploying a ligature from the end cap to ligate the persistently stained area of the mucosa of the lesion, the ligated persistently stained area of the mucosa of the lesion forming an artificial polyp while the artificial polyp is attached to the mucosa around the lesion;
• then withdrawing the second endoscope and leaving the artificial polyp attached to the mucosa around the lesion;
• moving the open distal end of the first endoscope toward the artificial polyp, and, by use of a snare through the first biopsy channel of the first endoscope, resecting the artificial polyp from the mucosa around the lesion;
• wherein both of the first and the second endoscopes contribute to the endoscopic mucosal resection and the first biopsy channel of the first endoscope is an only channel of the first endoscope configured to permit passage of an instrument through the first endoscope.