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What is polypectomy?
Polypectomy is a procedure for the removal of a polyp. A polyp is an unnatural mass of tissue that has grown inside a mucous membrane in the body. It most often develops in the colon and stomach. It also develops in the urinary bladder, uterus and nasal cavities. Some kinds of polyps may be cancerous. Gastrointestinal polypectomy is mostly conducted endoscopically by doing a colonoscopy or a gastroscopy. In rare cases a polyp may be too large to remove it endoscopically. Therefore in such a scenario, the polyp is removed surgically.
How is a colonic polypectomy performed?
A colonic polypectomy is usually done during colonoscopy. During this procedure a polyp that has developed in the lining of the colon and large intestine is removed. The removal of a polyp will relieve symptoms such as rectal bleeding, bowel irregularities, and abdominal pain.
How are different types of polyps removed during a colonoscopy?
The different methods used to do a polypectomy during a colonoscopy depend on the polyp’s shape, size and histological type.
How to prepare for a colonic polypectomy?
- Removal of Small Polyps
Small polyps can be removed by hot and cold biopsy.
- Hot biopsy is used to remove small polyps. In this procedure, the polyp is closed by biopsy forceps and electric current is passed to supply electrocautery. Chances of bleeding from the base of the polyp is reduced by this, and most often the polyp is removed completely as the tissue at the polyp base is destroyed.
- Cold biopsy is used to remove very small polyps that are up to 3mm. In this procedure the polyp is removed by biopsy forceps without providing electrocautery. This however, may cause the polyp to be removed incompletely. The risk of colonic perforation is removed in this procedure.
- Removal of Larger Polyps that are Sessile
It is difficult to remove larger sessile polyps endoscopically, and there is a high chance of complication. Snare polypectomy is used to remove sessile polyps that are up to 10mm. The polyps that are larger than 10mm need to be removed little by little by snare polypectomy. Electrocautery over a big region may case perforation of the colon. Therefore, sterile fluids may be injected at the polyp base to lift it from the colon’s muscular layers.
- Removal of Larger Polyps that are Pedunculated
These polyps are taken out by snare polypectomy which is passed around the polyp stalk. The snare’s loop is tightened around the polyp stalk and pulled away from the colon wall. Then, an electric current is passed through the loop of the snare that cuts the stalk of the polyp. The polyp is then removed.
- Before the polypectomy, the doctor may be required to do some tests on you which include:
- Physical checkup and examination of medical history
- Examination of the medicines you may be taking
- Stool test
- X-ray and barium enema
- Endoscopic examination of the intestine
- Your colon is thoroughly cleaned. The cleansing methods may include:
- Enemas: This is a fluid that is put into the rectum for the stimulation of bowel movement.
- Laxatives: These are medicines that enable soft bowel movements
- Following a clear-liquid diet
- Drinking fluids for stimulation of bowel movements
Duration of procedure/surgery : 30 to 60 minutes
Days admitted : None. Polypectomy is usually done on an outpatient basis.
Anesthesia : Local anesthesia
Recovery : - After the procedure, you may experience some bloating and cramping. This is due to the air that is filled in the colon. Passing of gas will ease this discomfort.
- Pain medicine may be prescribed if required.
- You will completely recover from the polypectomy within two weeks.
- The polyps are sent for lab analysis to confirm or decline the presence of cancerous or precancerous cells
- After the results, if the polyp is tested malignant, follow-up diagnostic tests are scheduled at regular intervals.
Risks : The risks that are involved are rare. They occur due the factors like the location, size, and type of the polyp. Risks also depend upon the medical conditions of the patients such as diabetes, obesity, and other diseases and disorders. These complications include:
- Perforation of the colon wall
- Reactions to sedative
After care : - Patients should not drive, operate machines, or consume alcohol for 24 hours after the procedure.
- Follow the doctor’s instructions carefully.
- Resume normal diet after the procedure.
- Avoid consuming tea, coffee, soft drinks, alcohol and spicy food for 2 to 3 days after the procedure.
- Resume normal activities. However, ask the doctor when you can take part in rigorous exercise.
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