Endoscopic Polypectomy
A Personalized Approach to Removing Polyps Before They Become a Problem
Most colorectal cancers begin as polyps small growths on the lining of the colon that develop slowly, often over many years, before any become cancerous. Endoscopic polypectomy, the removal of polyps during colonoscopy or upper endoscopy, is one of the most genuinely preventive procedures in all of medicine, turning a diagnostic examination into a direct intervention against future cancer.
The technique used to remove a polyp depends heavily on its size, shape and location. Small polyps can often be removed with a simple snare or forceps in seconds, while larger or flatter polyps may require more advanced techniques to remove completely and safely. In every case, the goal is the same: complete removal, with the tissue sent for analysis to confirm what it was and whether anything further is needed.
At the practice of Dr. Ashok Choudhury, polypectomy is approached with careful technique selection matched to each polyp, and a clear plan for what the pathology results will mean for future screening.
Polypectomy Turns Screening Into Prevention
Understanding the process makes clear why it matters so much
Finding a polyp during endoscopy can sound concerning, but in the vast majority of cases, its removal on the spot is precisely what prevents it from ever becoming a problem.
The next step is to understand:
- What size and type of polyp has been found, or may be found
- What removal technique is most appropriate
- Whether removal can be completed in the same session
- What happens to the tissue after removal
- What recovery involves afterward
- How the pathology result will affect your future screening schedule
The goal is complete, safe removal in a single session wherever possible, with a clear plan for what comes next.
Our Approach to Endoscopic Polypectomy
1. Assess the Polyp Carefully
Not all polyps are the same, and careful assessment guides the safest, most effective removal technique.
- Evaluating size and shape Small, stalked polyps are approached differently from larger, flat ones, since technique and risk vary considerably.
- Assessing location Polyps in certain locations within the colon may require specific technique adjustments for safe, complete removal.
- Considering number and pattern Multiple polyps, or specific patterns of polyps, may raise or lower suspicion for particular underlying conditions.
- Planning technique in advance Where a large or complex polyp is anticipated from prior imaging or reports, the appropriate technique is planned before the procedure begins.
2. Choose the Right Removal Technique
Matching technique to polyp type is central to both complete removal and safety.
- Cold snare polypectomy Used for many small polyps, this technique removes tissue quickly with minimal bleeding risk.
- Hot snare polypectomy Uses electrical current to remove larger polyps while sealing small blood vessels as it cuts.
- Endoscopic mucosal resection (EMR) Used for larger, flatter polyps, involving lifting the polyp with fluid injection before removal to ensure complete, safe excision.
- Piecemeal removal when necessary Very large polyps are sometimes removed in sections, with careful mapping to ensure no tissue is left behind.
3. Complete Removal Safely
Safety during the procedure itself is a central focus, particularly for larger or more complex polyps.
- Bleeding prevention and control Techniques such as clipping are used where needed to minimise bleeding risk, particularly after larger removals.
- Marking for future reference In some cases, the removal site is marked (tattooed) to allow easy identification at future examinations.
- Retrieving tissue for analysis Removed tissue is carefully collected and sent for pathological analysis without exception.
- Monitoring immediately afterward Patients are observed for a period after more complex polypectomies, with clear guidance on warning signs to watch for at home.
4. Interpret Results and Set the Screening Schedule
The pathology result is what determines your future risk and screening needs.
- Explaining the pathology report Findings including polyp type and any high-risk features are explained clearly once results are available.
- Assessing cancer risk Certain polyp types and features carry different implications for future colorectal cancer risk.
- Setting the next screening interval Results directly determine how soon your next colonoscopy should be, which may range from a few years to a much shorter interval.
- Considering family screening implications In some cases, findings may have relevance for family members’ own screening recommendations.
Why Complete, Careful Removal Matters
An incompletely removed polyp can regrow, while a well-characterised, fully removed one gives genuine peace of mind and a clear basis for future screening decisions. This is what makes thorough technique, and equally thorough follow-up, so central to effective polypectomy.
A Personalized Plan, Not a One-Size-Fits-All Answer
The right technique for your polyp, and the right screening schedule afterward, depends on the specific findings in your case. At the practice of Dr. Ashok Choudhury, this is handled with careful, individualised attention at every step.
If a polyp has been found during a previous examination, or you are due for colorectal screening, a consultation is the right place to start.
Disclaimer
This information is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Please consult a qualified healthcare provider regarding your specific condition.