Colon Polypectomy: Why It's Done, How to Prepare, and What to Expect

A polypectomy is a procedure that removes polyps and abnormal collections of tissue from the inside of the colon ( large intestine). It's a relatively noninvasive procedure that's often performed during a colonoscopy.

At Advanced Surgical Associates of Northern Minnesota, board-certified general surgeon Dr. John Bollins and his staff regularly perform colonoscopies for their patients as a preventive and diagnostic tool to detect colon cancer and other problems with the large intestine. Polyps are a common finding even in routine testing, so they perform polypectomies to biopsy the tissue and ensure it's not concerning. Here's what you need to know about the procedure.

What are colon polyps, and what causes them to develop?

A colon polyp is a small clump of cells that grows on the lining of the large intestine. While most polyps are harmless, some can turn into a cancerous mass. That's why detecting these growths early is important; the earlier they're removed, the better the outcome.

Anyone can develop colon polyps, but you're at higher risk if you're 50 or older, are overweight, or smoke. There's also a genetic component, so you're at risk if you have a family history of colon polyps or colon cancer.

Normal, healthy cells grow and divide in an orderly manner when new tissue is needed. However, mutations in certain genes cause cells to keep dividing, even when they're not needed, forming the abnormal mass.

Colon polyps don't usually cause symptoms, so regular screenings are important for early detection. Those discovered early in development can usually be removed completely and safely.

There are two basic categories of polyps: non-neoplastic and neoplastic. Non-neoplastic polyps generally don't become cancerous. Neoplastic polyps, though, include adenomas and serrated types. Adenomas are likely to turn cancerous if given enough time to grow. Serrated polyps can also become cancerous, depending on their size and location. Most of the time, the larger the polyp, the greater the cancer risk.

Preparing for the polypectomy

A colonoscopy uses a long, thin tube with a light and camera on the tip the doctor inserts into your rectum and snakes into the large intestine. So that the colonoscope can travel unimpeded, you must ensure your colon is empty of fecal matter. For this reason, you need to do a procedure prep, which, to be honest, is not at all pleasant. You need to be on a clear liquid diet for at least a day, and you use a special prep solution that acts like gastric "dynamite" to evacuate your bowels. Expect to be in the bathroom for several hours, at least the night before.

The polypectomy procedure

When it's time for the procedure, you lie on your left side with your knees pulled up to your chest, and the anesthetist gives you a painkiller and sedation so that you're completely relaxed and unaware of what's happening. Once you're out, Dr. Bollins inserts the colonoscope. If he detects a polyp along the way, there are several ways he can perform the polypectomy, which he chooses depending on the type of polyps present.

Polyps can be small or large, sessile or pedunculated. Sessile polyps are flat, while pedunculated polyps grow on stalks like mushrooms. The doctor can use biopsy forceps to remove polyps less than 5mm in diameter. Larger polyps (those up to 2cm in diameter) can be removed using a snare.

For the snare polypectomy, Dr. Bollins loops a thin wire around the bottom of the polyp and uses heat to cut the growth off. Any remaining tissue or stalk is cauterized.

Due to their large size, location, or shape, some polyps are associated with an increased risk of complications. As a result, the doctor may have to use more advanced techniques to remove them, up to and including bowel surgery. 

Once the polyp has been removed, the doctor sends it to a pathology lab to determine if it's cancerous. You should get the results of the tests in about a week.

Recovering from a polypectomy

Recovery is usually quick. You may experience minor side effects like gassiness, bloating, and cramps; they should resolve within 24 hours. If you had a more involved procedure, a full recovery may take up to two weeks.

Your doctor will give you aftercare instructions, which you should follow exactly. He'll also schedule you for a follow-up colonoscopy to check that the polypectomy was successful and that no further polyps have developed.

To learn more about what to expect from a colonoscopy and polypectomy and to schedule a consultation with Dr. Bollins, call us at our Hibbing, Duluth, Cloquet or Ely, Minnesota, office or book online.