Polypectomy with Hot Biopsy

There are three types of polyp removal procedures that include Colorectal Polyp removal, snare polypectomy and surgery for colon or rectal polyp. The reasons for performing the procedures involve removal of suspected cancerous tumours, repairing abnormal rectal bleeding and removal of abnormal tissues for examination at the pathology laboratory.

Snare polypectomy is a surgical procedure to remove predunculated and flat polyps to prevent them from becoming cancerous. Polypectomy with hot biopsy is used to eliminate small polyps, measuring up to 5 mm. Most gastrointestinal polyps are removed with colonoscopy.

When polyps grow within the inner lining of the colon, they are better accessed and removed by polypectomy combined with hot biopsy. The idea is to have a better grasp of the polyp tips with hot biopsy forceps to snare around the polyps. High-frequency electric currents are passed through the snare to cut off the tip of the polyp while thermally coagulating the vasculature lining.

The major advantage of polypectomy with hot biopsy is to minimize bleeding by avoiding a cold cut when closing the snare. Once cut off from the mucosal surface, the polyp is easily retrieved. Flat and regional polyps are best accessed with hot biopsy forceps that allow making twisted and rigid wire snares for the resection procedure.

The incisions made by the hot biopsy forceps depend upon the type of wires used, which are soft, pliable, thick, thin or crescent shaped. Soft and pliable wires require less force to close and open them while snaring the polyps, thick diameter wires minimize bleeding, thin wires ensure clean and rapid cut, while crescent-shaped wires help in easy capture of flat lesions. The type of wire chosen depends upon the share and size of the polyps.

Usually, large polyps are not cut in one step. Step-by-step resections are done to cut large polyps. Nowadays, large polyps are removed using piecemeal resection that reduces the risk of bleeding and ensures complete control during the surgery. Made out of a flexible sheath, the forceps and snares allow smooth insertion and passage through the polyps easily. Before Polypectomy treatment, you should follow a few instructions as discussed below.

• Talk with your doctor regarding your health condition, the medication you are taking and whether you have anyhealth concerns (related to the intestine, stomach, liver, heart, etc)
• After examining your medical condition, the doctor performs a few tests. For instance, a transvaginal ultrasound is done to detect polyps in the uterus. Uterine polyps are identified by the thickened area of the endometrial tissues. The doctor may also perform a hysterectomy procedure by inserting a hysterescope through the vagina into the cervix into the uterus.      Colonoscopy is another procedure for examining the colon and the rectum. A colonoscope is inserted through the rectum to look for any polyps inside the inner linings of the colon. Colorectal polyps usually grow in the colon that may turn cancerous later. Before polypectomy with hot biopsy procedure, others tests are performed to identify the location, shape, size of the polyps.
• The doctor prescribes certain medications, while he restricts a few previous ones so that no medicine may interfere with the surgical procedure.
• Diabetic patients should keep their blood sugar levels under control before undergoing the surgery. If not, your diabetologist may recommend insulin or a combination of other oral medicines.

• Take adequate rest before the procedure and take clear liquid drinks from the night before the surgery. Make sure you drink sufficient amount of water as advised by your doctor.

• Stop eating or drinking anything from the night before the surgery.

• You are sedated before the procedure begins to help you sleep through it.
• You are asked to lie down on your side with knees drawn towards your abdomen. The surgeon then places a tube with a camera fitted to it through the rectum or anus to see the large intestine.
• The surgeon then performs Polypectomy by removing the polyps with the aid of a snare made of electric current and wire. The snare is advanced to the polyp sites with endoscopic guidance. Once electric current is passed through the snare, it is then tightened to safely and quickly excise the polyps while coagulating the vasculature. It should be noted that the technique causes very little bleeding.
• While the smaller polyps are excised by inserting a tube, larger polyps are removed with laparoscopic procedure for which incisions are made in the abdomen. A tube is inserted through the cut that has a small camera fitted to it that helps to remove the polyp. In takes 30 minutes to an hour to perform the procedure.

After the procedure, you are transferred to the recovery unit where the doctor monitors your situation when the sedation wears off. There are certain possible risks associated with the procedure that include excessive bleeding from the wound and signs of infections arising from an accidental colon perforation. The doctor immediately takes care of the symptoms with the right medications and other techniques.

The recovery time of polypectomy with hot biopsy is normally 2-3 weeks. At home, you should start getting back to normal activities, complete your course of prescribed medicines, take stool softeners to help in its smooth passage, avoid taking aspirins, start taking antibiotic medications, etc. You should be on a liquid diet, until your gastrointestinal tract start to function properly.