Endoscopic polypectomy consist of the excision of colonic polyps during the procedure of colonoscopy and in performed much in developed countries.
Colonic polypectomy is the removal of colonic polyps to prevent them from turning cancerous. Gastrointestinal polyps can be removed endoscopically. This can be done through esophagogastroduodenoscopy; colonoscopy or surgically in case polyp is too big.
The method used to conduct polypectomies during colonoscopy is based on the histological type, shape and size of the polyp which must be removed. Prior to conducting this procedure, polyps may be subject to biopsy and examined histologically for determining the need for this procedure.
Such polyps are tough to remove endoscopically and polypectomy has a bigger potential for complications. Snares can be used in polypectomy to remove sessile polyps of up to 10 mm. Devices for snare procedure can be sourced from endoscopy polypectomy snare product manufacturers.
When electro- cauterization is used over a big area, it has a substantial risk of resulting in colonic perforation. For reducing this and to aid in polypectomy procedure, sterile fluid (colloid or sterile with addition of methyl blue) can be injected to the base of the polyp to uplift it from muscular layers of the colon.
Bigger, Pedunculated Polyps
These can be removed by snare polypectomy. When the Polyp is identified, a snare is passed over the polyp and around the stalk of the polyp. The doctor then tightens the loop of the snare, for gripping the polyp stalk and he pulls away the polyp from the wall of the colon.
Next, an electric current is passed through the snare loop for cutting through the polyp stalk, offering electro-cauterization at the same time. The doctor can retrieve the polyp using the snare or an endoscopy basket and remove it by withdrawal of colonoscope.
Snare Polypectomy for Small Polyps
Cold snare polypectomy is an easy to apply technique which has become popular for small and diminutive polyps. In brief, the endoscopist pushes the snare sheath, opens the snare and encircles the polyp. Then, the snare is progressively and slowly closed, with the objective of capturing 1 to 2 mm of normal tissue around the polyp till complete closure is achieved and the polyp is guillotined. After this, the polyp can be suctioned and retrieved for histological evaluation.
As per studies, cold snare polypectomy has been shown to be substantially superior to biopsy forcep removal with regard to histological eradication rate and time for procedure. Snare resection was more expensive and linked to a lower retrieval rate, compared to biopsy forcep retrieval but this quality was not statistically significant.