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Underwater endoscopic mucosal resection (uEMR) is an injectionless form of EMR that allows intestinal adenomas to be safely resected without creating a submucosal cushion [1]. Proponents of uEMR cite safety and effectiveness of the technique, as well as speed and higher en bloc and R0 resection rates [2]. Furthermore, mucosal lesions contract underwater, facilitating en bloc capture of lesions larger than the snare opening [3]. Despite this, suboptimal en bloc resection rates (89%) have been reported among intermediate-sized (10–20mm) lesions, with even lower R0 resection rates (69%) [4]. This suggests that the snares used were too small, resulting in piecemeal or incomplete removal. We have developed a technique – progresE-Videos

En bloc removal of a colonic polyp using progressive polyp contraction with underwater endoscopic mucosal resection: the PP-CUE technique