Abstract
All colorectal cancers arise in a benign neoplasm. Removal of the premaligant lesion is key to preventing cancer, but in some large or awkwardly placed lesions, removal can be risky and difficult. New techniques have been developed to facilitate effective and safe removal (such as endoscopic mucosal resection and endoscopic submucosal dissection), but these are associated with a steep learning curve. Many “difficult” polyps can be resected effectively using simple polypectomy. The purpose of this chapter is to describe ways of removing difficult lesions using simple techniques.
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Video 2.1 Piecemeal Polypectomy of an Ascending Colon Polyp. This patient was referred for a segmental colectomy; he has an extensive history of abdominal surgery and comorbidities including chronic obstructive pulmonary disease. A large sessile polyp in the proximal ascending colon is seen. Polypectomy is started with a hexagonal snare and is deliberately piecemeal. There is no submucosal injection of saline. After the bulk of the polyp is removed, a mini oval snare is used to clear the edges of the resection. A follow-up colonoscopy will be carried out in 4 months (MP4 118694 kb).
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Church, J.M. (2014). Difficult Polyps: Conventional Methods. In: Sonoda, T. (eds) Advanced Colonoscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1584-2_2
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DOI: https://doi.org/10.1007/978-1-4939-1584-2_2
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