Polypectomy- Ear Nose And Throat (ENT), Gastroenterology, Obstetrics and Gynecology

What is a polypectomy?

Polypectomy, a minimally invasive procedure, is performed to remove polyps (abnormal growths of tissue) from the inside of the colon. This procedure helps to evaluate whether a growth is non-cancerous, precancerous, or cancerous. Early detection and removal of polyps in colon would help to prevent the development of colorectal cancer.

Which Speciality to Consider?

A gastroenterologist (doctor specializing in the diseases of the stomach and the intestines) is the medical specialist who will perform the colonoscopy as well as the polypectomy

Why is it required?

Polypectomy is required when polyps are discovered inside the colon during the colonoscopy.  During polypectomy, the polyp is removed and the tissue is examined to determine whether a growth is non-cancerous, precancerous, or cancerous. Small polys do not show any symptoms. However, symptoms such as abdominal pain, rectal bleeding, and irregularities in bowel movement may appear due to the presence of large polyps. This procedure would also help to remove these symptoms.

What to expect during the procedure?

Polypectomy is performed by a gastroenterologist at the same time as a colonoscopy. Patient is given a sedative before the procedure. Depending on the types of polyps in the colon, the doctor would decide what type of polypectomy should be performed. Polyps can be of various types such as large, small, sessile, or pedunculated. Small polyps (< 5 mm in diameter) can be removed by using biopsy forceps. Large polys (around 2 cm in diameter) are generally removed by using a snare. Sessile polyps are flat in structure and do not have a stalk. And pedunculated polyps generally grow on stalks.

Cold forceps polypectomy is used to remove small polyps by using forceps to pull the polyp loose. A wire may be also used to remove the part of the polyp that extends into the tissue. While performing snare polypectomy, thin wire is looped around the bottom of the polyp and heat is used to cut the abnormal growth. Removal of large polyps is more complicated and techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) techniques are used to remove large polyps. In EMR, fluid injection that is made of saline is used. Before performing the resection, the polyp is lifted from the underlying tissue using a fluid injection. The polyp is removed piece by piece by a process called piecemeal polypectomy. In ESD, the polyp is removed in one piece by injecting the fluid deep into the lesion. Bowel surgery may be required if the larger polyps cannot be removed endoscopically. Removed polyps are evaluated to determine if they are cancerous or not.

Recovery process:

Depending on the procedure and patient’s pain levels, pain medications will be prescribed after the procedure. Recovery after polypectomy is usually quick. Patient may have minor side effects such as cramps, bloating, and gassiness that usually resolve within 24 hours.



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About the Author:

Dr. Anand Lakhkar is a physician scientist from India. He completed his basic medical education from India and his postgraduate training in pharmacology from the United States. He has a MS degree in pharmacology from New York Medical College, a MS degree in Cancer/Neuro Pharmacology from Georgetown University and a PhD in Pharmacology from New York Medical College where he was the recipient of the Graduate Faculty Council Award for academic and research excellence.  His research area of expertise is in pulmonary hypertension, traumatic brain injury and cardiovascular pharmacology.  He has multiple publications in international peer-reviewed journals and has presented his research at at prestigious conferences.