What Is a Polypectomy?

What to expect when undergoing this procedure

Illustration of a polyp being removed
SEBASTIAN KAULITZKI/Getty Images

Polypectomy is a minimally invasive procedure in which doctors remove abnormal growths of tissue, called polyps, from inside your colon. In addition to being a therapeutic procedure, a polypectomy is used as a means to assess whether a growth is cancerous, precancerous, or non-cancerous.

Purpose

You may need a polypectomy if you have a polyp inside your colon, which can be discovered during a colonoscopy—a routine exam recommended for adults 50 years of age or older to check for any growths that may indicate cancer. A polyp may also be detected during a non-invasive imaging test, such as a computed tomography (CT) scan, ultrasound, or a magnetic resonance imaging (MRI) scan when you are being evaluated for weight loss, bleeding, or other symptoms.

A polypectomy is performed whenever a polyp that needs to be removed is found, and the procedure is usually done during the very colonoscopy that reveals one. A polyp remaining inside the colon can bleed, grow, or become cancerous.

Often, when a polyp is removed, it is examined under a microscope like a biopsy, so that you and your doctor will know if it was cancerous and whether there is any evidence that any remaining tissue also needs removal.

Risks and Contraindications

A polypectomy can cause bleeding, a perforation, or an infection. If you need a polypectomy, your doctor may recommend that you discontinue blood thinners prior to the procedure.

If you have an infection of your gastrointestinal system, a polypectomy can trigger the spread of infection, so it is likely that your doctor will want you to wait until after the infection has resolved before you have the procedure.

A perforation, in which the bowel is cut, is a rare complication of polypectomy. If this happens, you will need emergency surgery to repair the lacerated bowel.

Before the Procedure

Your doctor will discuss polypectomy when he or she is explaining your routine colonoscopy. Since the two procedures, if needed, are typically done together, it's helpful to know what's entailed so you are prepared to consent to it. If you don't, you may need to go in for a polypectomy at another time, requiring you to prepare for the procedure all over again.

If your polyp is discovered on an imaging examination, such as a CT scan, then your doctor will explain the process of a colonoscopy with a polypectomy when discussing your test results.

Timing

A polypectomy should take 20 minutes to an hour. You will be given medication that makes you a bit sleepy, and some people continue to feel groggy from the medication until after a good night's sleep, so you should be prepared to take it easy for the rest of the day after your procedure.

Location

A polypectomy is generally done in a gastrointestinal (GI) procedure suite that is equipped with a colonoscope, as well as a screen that your doctor uses to visualize the images.

What to Wear

You can dress comfortably. You will be asked to undress from the waist down and to wear a gown throughout your procedure.

Food and Drink

To prepare a polypectomy, you will be asked to undergo thorough bowel preparation a day or two in advance to ensure that your colon is clear and free of any visual obstruction. This can involve the use of a laxative, enema, and a clear food diet. A clear fluid diet includes clear broths, gelatin, and juice (without pulp).

Cost and Health Insurance

In general, most health plans cover colonoscopy and polypectomy, but you may need pre-authorization. If you are paying for the procedure out of pocket, the cost will be in the range of $1500 to several thousand dollars.

What to Bring

You should be sure to have someone who can drive you home after the procedure, as you may be too groggy to drive safely.

During the Procedure

Your polypectomy will be performed by a gastroenterologist, who is a doctor specialized in diseases of the gastrointestinal system. You will also have either a nurse or an anesthesiologist (a doctor specialized in sedation) helping with the procedure.

Pre-Test

On the day of the procedure, you will have to sign in and fill out forms consenting to the procedure and payment.

The anesthesiologist or a nurse will ask if you have any allergies or prior adverse reactions to anesthesia. You will be given a medication to relax you and to make you sleepy, either by mouth or intravenously (IV). You will most likely remain awake during the procedure, which can take up to an hour.

Once you are prepped and dressed in a hospital gown, you will be laid on your side on the examining table with your knees pulled toward your chest.

Throughout the Procedure

When ready, the doctor will insert a long, flexible colonoscope, which is connected to a camera, into your rectum. You may feel a slight pressure, but it shouldn't hurt. Depending on the room setup, you may be able to see the screen that your doctor is viewing.

Once your doctor locates a polyp, you will have it removed with one of two different types of polypectomies:

  • Snare polypectomy is a technique in which the doctor loops a thin wire (snare) around the base of the polyp and uses heat to simultaneously cut off the growth and cauterize (stop bleeding) the wound.
  • Piece-meal polypectomy is used to remove large growths that would otherwise be removed by surgery. If a person is unable to undergo bowel surgery, this technique removes the growth piece by piece during the course of a colonoscopic procedure.

You may have a local anesthetic injected in the area to prevent pain.

The growths themselves can be small and uncomplicated or they may be large pedunculated polyps that grow on stalks like a mushroom. If you have bleeding, your doctor may need to place a suture to stop the bleeding.

Post-Test

After your procedure, your doctor will remove the colonoscope and give you a chance to change and rest. The medical staff will give you instructions explaining what to expect and the symptoms to look out for.

It is not unusual to feel groggy and unsteady on your feet. As such, it is advised that a friend or family member drive you home.

The polyps that were removed are sent to a pathology lab to assess whether there is any sign of colon cancer. Results are usually available within a few weeks.

After the Procedure

While there is usually little pain following the removal of a smaller polyp, pain medication may be prescribed if the removal has been extensive or if your pain is severe. If you did not leave with a prescription but are experiencing pain, call your doctor's office to discuss your symptoms.

The risks of polypectomy are similar to those of the colonoscopy and can include rectal bleeding and perforation of the bowel. While these complications are considered rare, you should contact your doctor immediately if you experience any of the following adverse symptoms:

  • Fever or chills
  • Heavy bleeding (more than a teaspoon at a time)
  • Severe abdominal pain or bloating
  • Vomiting
  • Lightheadedness, dizziness, or fainting

Interpreting Results

The results of a polypectomy include a report about the type of lesion that was removed, as well as whether the whole lesion was removed or not. The report will also describe whether there were any cancerous or pre-cancerous cells, or whether the tissue was completely normal.

With this, the report will include a description of whether the margins (the edges of the lesion) were normal or whether they contained cancerous or pre-cancerous cells. When there are areas of concern, normal margins suggest that the concerning areas were fully removed, while margins that contain worrisome cells suggest that the cancerous or precancerous lesions were not fully removed.

Follow-Up

A polypectomy does not need to be regularly repeated. However, if there are areas of concern that were not fully removed, your doctor may schedule you for another procedure to remove remaining lesions or may order follow-up imaging studies.

If there was no evidence of cancer noted on your lab reports, you will need to continue to have routine colonoscopies.

A Word From Verywell

A polypectomy can cause concern because it is a procedure, not a simply screening test. While a polyp certainly is something that requires attention, the vast majority of polyps are benign and, when removed in a timely manner, do not pose a danger to your health.

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