Polyp Removal

If your gastroenterologist (GI doctor) or other medical provider finds polyps during your colonoscopy, there is a large chance that you will need to undergo a polyp removal. Polyps are not always dangerous, but it’s a good idea to remove all adenomatous, or pre-cancerous polyps before they get a chance to turn malignant, or cancerous. Getting polyps removed from your system is a great way to prevent colon cancer from either developing or spreading. Patients with a history of polyps in their family’s medical histories should be screened regularly to ensure that pre-cancerous polyps be removed as soon as possible.

In medical terms, the procedure is known as a polypectomy, or a colonic polypectomy. During a colonoscopy, the doctor can usually perform the polyp removal right then and there, to prevent the patient from having to undergo another colonoscopy later. During a colon polyp removal, abnormal growths along the wall of the gastrointestinal (GI) tract are surgically removed through the use of devices inserted into the body via the colonoscope.

Polyp Removal Procedure

The polyp removal procedure varies depending on the size of the polyp. Smaller polyps can be removed using a small tool with a cutting apparatus attached to the end. The device is inserted into the colonoscope and guided through the GI tract to the location where the polyp has started to grow. The surgeon can simply cut off extra tissue while viewing the inside of the patient’s body on a television monitor. For larger polyps, a different device called a noose or snare is used. The device has a small, electrical wire attached to the end of it, which loops around the base of the polyp and squeezes it until it burns off. This method, called cautery, is useful in removing larger polyp from the colon and also in preventing the patient from bleeding too much internally after the procedure.  If a polyp is too flat or too large to cut off safely in its natural state, the endoscopist will sometimes perform a saline or methylene blue injection underneath the polyp (also done through the endoscope).  This lifting procedure is then followed by a snare removal of the flat surfaced polyp.  This procedure is referred to as endoscopic mucosal resection or EMR.

How Does a Colon Polyp Removal Feel?

The polyp removal itself is actually painless because the inside of the colon lacks any of the nerve endings needed to feel pain. However, a polyp removal is almost always paired with a colonoscopy, so that surgeons can gain access inside the colon. Unfortunately, patients usually find the process of bowel prep and sedation before a colonoscopy quite burdensome, even though many patients do not even remember the colonoscopy or polyp removal procedure once it’s been completed. Patients are required to completely empty their bowels the day before their colonoscopy procedure by using laxatives and by avoiding solid foods. The reason for this is that any residual fecal matter can be mistook for a polyp or other sign of colon cancer during the colonoscopy procedure.

After a Polypectomy

Soreness in and around the rectal and abdominal area is normal after a colonoscopy. Patients also may feel weariness for a few days after the procedure.  After colonoscopy t he patient will return to a recovery area, where they will be asked to pass gas prior to leaving.  You will always need a ride home after a colonoscopy, since the sedative medications will still be in your system making it unsafe to operate a vehicle.  Although polypectomies are generally safe procedures, about 1 in every 1 thousand patients does experience perforation, or tearing, of the colon wall after polyps have been removed. Any post-procedural bleeding that occurs can usually be controlled, but tearing of the colon wall may require surgery to repair, and very rarely leads to death.

Overall, a colon polyp removal is one of the most important procedures a patient at risk for colon cancer can decide to have. Leaving polyps unmonitored leaves a big chance that those polyps will turn malignant and spread quickly. Talk to a colonoscopy specialist if you feel you need to check for colon polyps.

Reviewed 12/12/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014