Gel Immersion Improves Visualization in Underwater Endoscopic Mucosal Resection for Colorectal Lesions: A Prospective Crossover Trial.
J Gastroenterol HepatolJul 19, 2026 (epub)
Junki Toyosawa, Yasushi Yamasaki, Hidetaka Mizushima et al.
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In 30 seconds
This prospective randomized crossover trial evaluated the impact of gel immersion on lesion visibility during underwater endoscopic mucosal resection (UEMR) for colorectal adenomatous lesions. In a cohort of 72 lesions, gel immersion significantly improved color difference (ΔE) values compared to water immersion in white light imaging (WLI) and blue laser imaging (BLI) (p = 0.03).
Key findings
- ΔE values were significantly greater with gel immersion than water in WLI (p = 0.03).
- ΔE values were significantly greater with gel immersion than water in BLI (p = 0.03).
- Visibility scores were significantly higher with gel immersion in WLI and BLI under poor bowel preparation.
Why it matters
Improving visualization during endoscopic procedures can enhance diagnostic accuracy and therapeutic outcomes, particularly in challenging conditions such as poor bowel preparation. This study suggests that gel immersion may be a beneficial adjunct in UEMR.