Polypectomy

What is Polypectomy?

Polypectomy is a medical procedure used to remove polyps from the inside of the body, most commonly from the colon, stomach, or other parts of the gastrointestinal (GI) tract. Polyps are small, abnormal tissue growths that can develop on the inner lining of these organs. While many polyps are non-cancerous (benign), some have the potential to turn into cancer over time, especially if left untreated.


Polypectomy is considered a safe and effective way to prevent the progression of certain types of cancer, particularly colorectal cancer. It can be done as a day procedure, meaning patients typically go home the same day.

Who is Suitable for Polypectomy?

Polypectomy is suitable for individuals diagnosed with polyps in the gastrointestinal tract, often discovered during routine screening tests such as a colonoscopy. People at higher risk for developing polyps include:

  • Adults over the age of 50
  • Individuals with a family history of colorectal cancer or polyps
  • Patients with inflammatory bowel diseases like ulcerative colitis or Crohn’s disease
  • People who have previously had polyps removed


Polyps may not cause symptoms, which is why screening is important. However, in some cases, symptoms such as rectal bleeding, changes in bowel habits, or abdominal pain may prompt a doctor to investigate further.


Benefits of Polypectomy

The primary benefit of polypectomy is the prevention of cancer, particularly colorectal cancer. Since some polyps can develop into cancer over time, removing them early significantly reduces this risk.


Other benefits of polypectomy include:

  • Minimal invasiveness: The procedure is typically done using an endoscope, without the need for open surgery.
  • Short recovery time: Most patients can resume normal activities within a day or two.
  • Immediate treatment: Polyps can often be removed during the same procedure in which they are found.
  • Diagnostic value: Once removed, the polyp can be sent to a laboratory to determine if it contains abnormal or cancerous cells. This helps guide future monitoring and treatment.


Types of Polypectomy

There are several types of polypectomy, and the method used depends on the polyp's size, type, and location. Common types include:

  • Cold snare polypectomy: This method is used for small polyps (usually less than 10mm). A wire loop (snare) is placed around the polyp, and it is gently removed without the use of heat. This reduces the risk of damage to the surrounding tissue.
  • Hot snare polypectomy: This technique uses a similar wire loop but with electrical current (cautery) to cut and seal the tissue simultaneously. It is often used for medium to large polyps or those with a stalk (pedunculated polyps).
  • Endoscopic mucosal resection (EMR): EMR is used for larger or flatter polyps that cannot be easily removed with a snare. A solution is injected under the polyp to lift it from the wall of the intestine, making it easier and safer to remove.
  • Endoscopic submucosal dissection (ESD): This is a more advanced technique used for very large or complex polyps. It involves carefully cutting beneath the polyp to remove it in one piece. ESD requires specialised training and is typically done in hospitals with expertise in advanced endoscopy.


Alternative Options to Polypectomy

In most cases, polypectomy is the preferred and safest treatment for polyps. However, there are some alternative approaches depending on the specific circumstances:

  • Surveillance and monitoring: In some cases, if a polyp is very small and not considered high-risk, your doctor may recommend regular monitoring rather than immediate removal. Follow-up colonoscopies can help track changes over time.
  • Surgical removal: For very large or deeply embedded polyps, or if there is a suspicion of cancer, surgical removal of a section of the bowel may be necessary. This is usually done through minimally invasive (laparoscopic) or traditional open surgery.
  • Advanced endoscopic procedures: If a polyp is too large or complex for a standard polypectomy, referral to a specialist centre for EMR or ESD may be required.


What to do Before a Polypectomy?

Before a polypectomy, your doctor will give you specific instructions to prepare for the procedure. Preparation is important to ensure the bowel or stomach is clear so the polyps can be seen and removed safely.


For a colon polypectomy, this usually includes:

  • A bowel preparation (also called a bowel prep), which involves drinking a special solution that cleans out your intestines.
  • Following a clear liquid diet the day before the procedure.
  • Avoiding certain medications, such as blood thinners or iron supplements, as advised by your doctor.


For stomach or upper gastrointestinal polypectomy, you will likely be asked to fast (no food or drink) for several hours before the procedure.

Always tell your doctor about any medications you’re taking, allergies, or underlying health conditions. Your healthcare team will provide clear guidance tailored to your needs.


What Happens During a Polypectomy?

A polypectomy is usually performed during a colonoscopy or gastroscopy. These are endoscopic procedures done under light sedation to keep you comfortable and relaxed.


Here’s what typically happens:

  • You will be asked to lie on your side while a thin, flexible tube with a camera (called an endoscope) is gently inserted through the rectum or mouth, depending on the location of the polyp.
  • The doctor will carefully examine the lining of the gastrointestinal tract.
  • If a polyp is found, special tools such as snares or forceps are passed through the endoscope to remove it.
  • Depending on the size and type of polyp, different methods (cold snare, hot snare, EMR, etc.) will be used to safely remove it.
  • The removed tissue is usually sent to a pathology lab for further analysis.


The entire procedure typically takes between 20 to 60 minutes. Since you’ll be sedated, you won’t feel any pain during the process.


What to Expect After a Polypectomy?

After the procedure, you’ll be taken to a recovery area where you’ll rest until the sedation wears off. Most people can go home the same day, but will need someone to drive them due to the lingering effects of sedation.


Common experiences after polypectomy include:

  • Mild cramping or bloating due to air introduced during the procedure
  • A small amount of blood in the stool, especially after larger polyp removal
  • Feeling tired for the rest of the day


You should avoid alcohol, driving, and making major decisions for 24 hours after sedation. Your doctor may advise you to avoid strenuous activity or heavy lifting for a short time, especially if larger polyps were removed.


In most cases, you can resume a normal diet shortly after the procedure. Your doctor will let you know if any dietary restrictions are needed.


If you experience heavy bleeding, severe abdominal pain, fever, or vomiting, seek medical attention immediately.


Why Polypectomy? 

Polypectomy has an excellent prognosis, especially when polyps are found and removed early. In many cases, removing a polyp eliminates the risk of it developing into cancer.


Once a polyp is removed, it is sent for laboratory testing to check whether it is benign, pre-cancerous, or cancerous. Your doctor will discuss the results with you and explain what follow-up may be needed.


Some people may require more frequent screening if they have a history of multiple polyps, certain genetic conditions, or a family history of colorectal cancer. Others may return to routine screening every 5 to 10 years.


Overall, polypectomy is a reliable, low-risk procedure with significant long-term benefits.


Polypectomy Risks

While polypectomy is generally safe, like any medical procedure, it carries a small risk of complications. These may include:

  • Bleeding at the site where the polyp was removed (more common with larger polyps)
  • Perforation or a tear in the bowel wall (rare, but more likely with large or deeply embedded polyps)
  • Infection (uncommon)
  • Reactions to sedatives used during the procedure


Your doctor will discuss these risks with you beforehand and take all necessary precautions to minimise them.


If bleeding occurs, it is usually mild and resolves on its own or with simple treatment. In rare cases, further medical care or surgery may be needed. Perforations are also rare and typically treated with surgery or endoscopic repair.


The risk of complications increases slightly if multiple polyps are removed or if advanced techniques are used, but your doctor will closely monitor you to ensure safety.


What if Polypectomy is Delayed?

Delaying a recommended polypectomy can increase the risk of health complications. While many polyps are benign, some can slowly develop into cancer over time, particularly in the colon.


Here’s what may happen if polypectomy is delayed:

  • Polyps may grow larger and become more difficult to remove
  • The likelihood of polyps turning into cancer increases
  • Treatment may become more complex, requiring surgery instead of a simple endoscopic removal
  • Early symptoms such as bleeding, pain, or bowel changes could worsen


For high-risk patients or those with a history of cancer in the family, delaying the procedure may result in missing the critical window for early detection and prevention.


Discussing your concerns about the procedure, recovery, or costs with your gastroenterologist is important. Your care team can help you make an informed decision and create a plan that ensures your safety and peace of mind.