Advanced Polypectomy

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Advanced Polypectomy

An advanced polypectomy is a procedure to remove a large polyp in your bowel or polyps that are difficult to access.

Polyps develop when the cells in the bowel grow out of control forming a clump which gradually becomes more prominent within the inner lining of the bowel over time they can grow through the deeper layers of the bowel as malignant (cancer) cells. It is important they are removed if possible in one piece with a clear margin of normal tissue.

Most polyps can be removed at the time of a colonoscopy, except for the very smallest we use an advanced technique for removal called endoscopic mucosal resection (EMR) because this is the safest method that enables the most complete removal.

It is difficult to tell with certainty if a polyp contains cancer cells unless it is completely removed and sent to the pathology laboratory and examined under a microscope, the processing time is at least 5 to 7 days.

Larger polyps or early cancers cannot be safely or adequately removed at colonoscopy, traditionally a major operation to resect the affected section of bowel was required.

If a polyp is identified during a colonoscopy it will be removed during the procedure providing it is not too large and you are not taking any blood thinning medication.
An advanced polypectomy (EMR) usually takes between 5 and 20 minutes, you feel no pain, the polyp is lifted away from the deeper layers of the bowel by injecting a special liquid then removed with a fine metal snare using an electric current.

Advanced polypectomy therefore lengthens the time taken to perform the colonoscopy, it is associated with a slightly higher risk of some bleeding and bowel perforation but this risk is still less than 1 in 500.

Will be the standard preparation for a colonoscopy.

Afterwards you will be taken to the recovery area where your blood pressure and pulse will be monitored.

We will nearly always be able to come and talk to you after the procedure to discuss the results; we will provide you with a report. You will be able to go home the same day although you will not be able to drive and you will need someone with you for 24 hours.

For advice regarding any symptoms after the procedure read more about the colonoscopy procedure.

We will usually see you in clinic about 2 weeks after an advanced polypectomy to discuss the results of laboratory testing.

Read our answers to Frequently Asked Questions by other patients of Windsor Bowel Clinic

Trans anal endoscopic microsurgery (TEMS)

We specialise in an operation via the anal canal which can adequately remove these lesions if they are located in the lower part of the bowel, the procedure is called trans anal endoscopic microsurgery (TEMS) or trans anal minimally invasive surgery (TAMIS).

The TEMS or TAMIS procedure is suitable for larger polyps or early cancers in the lower part of the bowel that are not appropriate to remove at colonoscopy. We have specific expertise in this procedure which is performed under a general anaesthetic with special equipment via the anal canal.

The large polyp is removed with a disc of bowel which is then sutured closed and so has lower risks and lower probability of requiring a stoma than a conventional large operation to remove a section of bowel.

Depending on where the polyp is in your lower bowel, you will either have an enema about an hour before the procedure or have full bowel preparation with strong laxatives (the same preparation for a colonoscopy).

You will have very little pain, you may have less control of liquid stool for a few days. If you are well after 1 night in hospital you will be discharged home on 5 days of antibiotic tablets (usually metronidazole. You must not drink alcohol when taking this antibiotic).

We will see you in clinic about 2 weeks after the operation with the pathology laboratory results.

Find out about the consultants that will be looking after you, and their expertise in bowel and hernia diagnosis and treatment

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