How Are Polyps Removed?
We talked a little bit about colon polyps in our last post. Many patients are curious as to exactly how polyps are removed during colonoscopy. Today we will discuss that very topic. To be honest with you, the techniques we have for removing polyps during a colonoscopy are pretty amazing!
The vast majority of polyps are removed using:
1) Biopsy forceps- “cold” versus “hot”
2) Snare-“cold” versus “hot”
Biopsy forceps can be “cold” meaning that there is no electric current passing through the forceps, or they may be “hot” in which case monopolar electric current is transmitted to the tissue through the forceps. Polyps appropriate for removal with a biopsy forceps are usually quite small-up to 3 millimeters for a cold forceps and up to 4 mm for a hot forceps.
The forceps is really a tiny set of “tweezers” on a long wire that can be passed down a long hollow channel in the colonoscopy. The tweezers can be opened and closed by the technician assisting the colonoscopist. When a tiny polyp is identified, the forceps is slid down the scope, and the polyp is grasped with the open jaws of the tweezers which are then closed. If “hot” forceps are used, an electric current is passed through the forceps to obliterate the tissue, then the polyp is “plucked” off the wall of the colon with the forceps. The polyp tissue is then retrieved and sent to the pathology laboratory. If “cold” forceps are used, the polyp is grasped and plucked off the wall of the colon without any electric current.
Here is what a biopsy forceps looks like:
Here is the "business end" of a biopsy forceps:
Here is a polyp being removed with a "hot" biopsy forceps. Note the the polyp tissue is whitish color-the result of "blanching" of the tissue from the electric current:
Next time we will discuss the snare technique for polyp removal-so stay tuned!!