A polypectomy is an endoscopic procedure to remove polyps from inside the bowel, most commonly the large intestine (colon) or the rectum. Its aim is to prevent abnormal growths that could develop into cancer, and to treat lesions that have already been found.
Before
The procedure is usually performed during a colonoscopy, so the bowel needs to be fully cleaned beforehand (bowel preparation) with a special diet, laxative liquids or a bowel prep solution.
Duration
Let your doctor know about any medications you take, especially blood thinners or antiplatelet drugs. You may be asked to stop them temporarily.
After
If sedation is planned, bring someone with you and avoid driving after the procedure.
If a polyp is found unexpectedly during a colonoscopy, you are already prepared from that procedure.
- During the colonoscopy, the polyp is located on the wall of the colon or rectum. The scope carries instruments through which it can be removed.
- Removal techniques include:
- Cold polypectomy: suited to very small polyps, with no heat used.
- Hot (snare) polypectomy: a thin metal loop (snare) is tightened around the polyp, and an electrical current is used to cut it and stop any bleeding.
- Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD): for larger or flat polyps, or where invasion is suspected.
- Once removed, the polyp tissue is sent to the lab for histological examination. This is key to determining whether it is benign, precancerous or cancerous.
- How long it takes depends on the number, size and location of the polyps: usually 15 to 30 minutes, or longer in complex cases.
What It Achieves
- Removing polyps early reduces the risk of developing colorectal cancer.
- It allows an accurate assessment of the lesion’s form, type and potential to progress, and helps determine when you should be checked again.
After a Polypectomy
- You will be monitored for a short time in the recovery area, as you may feel mild discomfort, bloating or a sensation of trapped air from the air/CO₂ introduced during the colonoscopy.
- If you were sedated, you should not drive or operate machinery for the rest of the day.
- Your doctor will go over the results and any further instructions (diet, avoiding strenuous exercise, possible medication advice).
- When you will need your next colonoscopy depends on the histology results and the number and type of polyps removed. For example, if 1–2 adenomas smaller than 10 mm were completely removed, the next colonoscopy may be scheduled in 7–10 years.
Possible Risks & Complications
A polypectomy is generally considered safe, but like any invasive procedure it carries some risks:
- Bleeding: the most common complication after removal.
- Perforation of the colon: rare, but serious.
- Post-polypectomy coagulation syndrome: pain, fever or a raised white blood cell count (leukocytosis), which occurs when the electrical current has caused prolonged thermal injury to the bowel wall.
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