Polyps are growths that occur primarily in the colon (distal-most portion of the lower bowel).  Polyps may cause bleeding and discomfort for the patient.  More importantly, polyps are sometimes pre-cancerous.  That is, if not removed they may turn into cancerous tumors. Thus, when the endoscopist observes polyps, he/she will usually remove them.

There are two types of polyps:  pedunculated and sessile.  Pedunculated polyps appear almost mushroom-like.  That is, the polyp has a stalk which attaches to the colon wall.  The endoscopist maneuvers the snare loop to capture the polyp while observing endoscopically.  He/she will then instruct the assistant to close the snare loop.  Then, electric current from a generator is applied to the polyp as pressure is applied to the snare loop via the handle.  The snare will cut the stalk of the polyp and coagulate the tissue at the same time, minimizing bleeding.

The choice of snare loop size and shape is dictated by the location and size of the polyp and by physician preference.

Sessile polyps differ from pedunculated polyps in that they have no identifiable stalk.  They can still be removed with a snare as described above.  However, in some cases (particularly when the polyp is small), hot biopsy forceps are used instead.  The endoscopist will bite the polyp with the forceps, and then apply coagulating current.

In both types of polypectomy, it is extremely important to retrieve the polyp (or polyp tissue).  The tissue is analyzed for cancerous cells.  If cancer is confirmed, colon surgery may be required.


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