Use of gelofusine for endoscopic mucosal resection

We read with interest the recent clinical case by Sarkar et al 1 and subsequent letter by Ignjatovic and Saunders,2 where the use of gelofusine and the endoscopic mucosal resection (EMR) technique were discussed. Gelofusine is a succinylated gelatin most commonly employed in fluid resuscitation, with a lower osmolality than 0.9% saline. Since 2004, we have routinely used an ‘EMR mix’ comprising 43 ml gelofusine, 5 ml 0.8% indigo carmine dye and 2 ml of 1:10 000 adrenaline, for the resection of flat and sessile lesions at our institution. Variable quantities of this mix are injected into the submucosal space using a 25 gauge needle, to cause sufficient lift of the lesion for resection (figure 1). Whilst …