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Thursday, July 12, 2012

Wednesday, July 4, 2012

Removing Polyps With Snare

Snare Polypectomy We have discussed the use of the biopsy forceps to remove polyps. That technique is generally limited to the removal of smaller polyps-usually less than 5 millimeters. Larger polyps are generally removed using the snare technique. Just like the use of biopsy forceps, snares can be "hot" or "cold"-meaning that electrocautery is used or not used. A snare is basically a wire lasso that is placed around a polyp, then tightened around the polyp tissue to cut off the polyp.

Generally, the cold snare technique is limited to smaller polyps. The hot snare technique-ie the use of electrocautery-is employed in the removal of larger polyps since the cautery provides hemostasis(bleeding control) by essentially sealing off small blood vessels the may be severed during the removal of the polyp. Because polyps come in various shapes and sizes, the snare technique is adjusted based on the polyp. Let me give you an example. Some polyps are "pedunculated", meaning they grow on a stalk-almost like a cherry on a stem.
To remove such a polyp, the snare is placed around the polyp, and the stalk is severed by tightening the snare and at the same time using electrocautery current through the wire. The diagram below shows a good representation of a snare polypectomy of a pedunculated polyp.
Once the polyp has been removed with this technique, there is usually a small burn mark on the wall of the colon, as seen below(the small whitish area).