A therapeutic procedure in which polyps detected during endoscopy are cut from the intestinal or gastric wall using a special snare or forceps.
Indication
- Colon polyps detected during colonoscopy
- Gastric or duodenal polyps seen during upper GI endoscopy
- Adenomatous polyps with size, shape, or histology that carry a cancer risk
- Polyps causing symptoms (bleeding, obstruction, anemia)
- Removal of polyps in the follow-up of familial adenomatous polyposis (FAP)
- Recurrent polyps after a previous polypectomy
Preparation
- 6–8 hours of fasting for upper GI polyps; full bowel preparation (PEG) for colon polyps
- Adjustment of aspirin, clopidogrel, and other blood thinners with the physician's approval
- Coagulation tests, complete blood count, and blood typing if needed
- Coming with a companion on the day of the procedure (no driving after sedation)
- Separate planning of diabetes and blood pressure medications for the morning of the procedure
How it's performed
- Intravenous access is established and the endoscopy is initiated under sedation
- When a polyp is detected, its size, shape, and location are evaluated
- Pedunculated polyps are tightened with a thin wire snare
- For flat polyps, saline injection beneath the base may be used to lift the mucosa (EMR)
- The polyp is cut in a controlled manner with electrocautery; bleeding is prevented with clips or argon plasma if needed
- The removed polyps are sent for pathological examination
Post-procedure
- Observation for 1–2 hours after sedation
- A short hospital stay may be recommended if a large polyp is removed
- Heavy lifting, intense exercise, and aspirin/blood thinners are restricted for 1–3 days
- Light/soft food for the first 24 hours; gradual return to a normal diet thereafter
- Follow-up colonoscopy is planned within 3–5 years based on the pathology and number of polyps
Risks
- Post-procedure bleeding (early or late, approximately 1–2%)
- Perforation of the bowel or gastric wall — around 1 in 1000
- Post-polypectomy coagulation syndrome (transient abdominal pain and fever)
- Cardiorespiratory complications related to sedation
- Recurrence or residual tissue if the polyp cannot be completely removed
FAQ
Is every polyp cancer?
No. Most polyps are benign. However, some types (especially adenomatous polyps) carry a risk of becoming cancerous over time, which is why they need to be removed and examined pathologically.
Can polyps recur after polypectomy?
Yes, they can. For this reason, follow-up colonoscopy every 3–5 years is recommended based on pathology and polyp characteristics.
What should I do if I bleed?
If fresh or clotted blood is seen in the stool within a few days after the procedure, a physician should be consulted. Late bleeding can occur up to 7–14 days afterwards.
Is polypectomy painful?
No pain is felt during polyp removal because there are no pain receptors on the bowel wall. The procedure is performed under sedation.
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