How is colonoscopic polypectomy performed?

The colonoscopic polypectomy procedure involves the following steps:

1. Patient Preparation: To ensure a clear view, the bowel must be cleansed using laxatives or enemas. Patients are usually given sedation (light anesthesia) before the procedure.
2. Colonoscope Insertion: A colonoscope—a flexible tube with a camera at the end—is inserted through the anus to examine the bowel.
3. Polyp Removal: Detected polyps are removed using specialized instruments passed through the colonoscope.
4. Sending the Polyps for Pathology:
   • The removed polyps are sent for pathological examination to assess their potential cancer risk.

What are the polypectomy techniques?

The technique used for polypectomy depends on the size, type, and location of the polyps:

Endoscopic Mucosal Resection (EMR): This technique is used for larger or flat polyps. A fluid is injected underneath the polyp to lift it from the colon wall, making removal easier. EMR allows for the removal of large polyps without the need for surgery.

Endoscopic Submucosal Dissection (ESD): A more advanced method used for high-risk or early-stage cancerous polyps. The polyp is removed in one piece by dissecting it from the submucosal layer, offering effective treatment even in early cancer stages.

Colectomy: In cases where polyps are very large or cancer is suspected, a colectomy may be necessary. This involves the surgical removal of a portion of the colon, along with nearby lymph nodes if needed.

What happens after polypectomy?

Most patients are discharged the same day after the procedure. Mild bloating or gas may occur. In rare cases, complications such as bleeding or bowel perforation may develop.