What you need to know about a polypectomy
However, a polypectomy can be performed on any area of the body that develops polyps, such as the nose or stomach. A polyp is a growth that begins in the tissue and extends into the hollow space.
A polypectomy removes polyps that are causing symptoms, that may be cancerous, or that need to be examined.
- Most polyps are benign growths, which means they do not contain cancer.
- In most cases, a polyp can be removed while the patient is awake.
- The right technique for polyp removal depends on the size and location of the polyp.
- Polypectomies are safe, with a low rate of complications.
Types of polypectomy
Polyps are quite common, and a polypectomy can be a relatively quick and simple procedure.
The two most common types of polypectomy are:
- Uterine polypectomy: To remove polyps in the endometrial tissue, the tissue that lines the uterus.
- Colon polypectomy: To remove polyps in the colon.
Polyps may also develop in other regions of the body. Some other relatively common sites of polypectomy include:
- the nose
- the cervix
- the vocal cords
- the stomach
What are polyps?
Polyps grow out of tissue into hollow spaces in the body. For example, colon polyps begin in the tissue of the colon, then extend into the hollow space.
Most are benign; some are cancerous, some are precancerous. It's not possible to rule out cancer without examining the polyp, so many doctors recommend routine removal to test for cancer.
Are they common?
Polyps are common, and most people don't know they have them. Between 20-30 percent of Americans have colon polyps. Uterine polyps become more common as a woman ages, and are highly prevalent in menopausal women. Just 3-5 percent are cancerous.
How big do they get?
Even when a polyp isn't cancerous, some polyps grow very large. When they do, they may alter blood flow, put pressure on organs, and cause a range of other symptoms.
Anesthesia is not always required for a polypectomy. A sedative may be used if anesthesia is not.
Preparation for a polypectomy depends on the surgical technique and the location of the polyps.
People undergoing removal of uterine polyps with local anesthesia may need no special preparation.
However, colon polypectomy requires the colon to be empty. Patients may need to use enemas, laxatives, or both in the 12 to 24 hours before surgery.
Surgical techniques and what to expect
Many patients prefer to be awake for the procedure. Others may want general anesthesia. The doctor will give the patient a sedative, usually through an intravenous (IV) needle. This makes the patient feel drowsy and relaxed.
Most polyps can be removed with a scope. This is a tube the doctor inserts into the body that eliminates the need for a large incision. For a uterine polypectomy, a doctor inserts the scope through the vagina, into the cervix, and into the uterus. A camera helps guide the scope to the polyp.
During a colon polypectomy, the doctor inserts the tube through the rectum. As with a uterine polypectomy, a camera helps the doctor locate the polyp.
Doctors use different surgical techniques for removing polyps. The specific removal technique is unlikely to affect the patient's experience of the surgery.
- Cold forceps polypectomy: Commonly used with small polyps, this technique uses forceps to pull the polyp loose. The surgeon will also use a wire to remove the portion of the polyp that extends into the tissue.
- Hot forceps polypectomy: This technique is similar to cold forceps removal. In addition to grabbing the tip of the polyp, however, a surgeon uses a procedure called electrocautery to burn away any remaining polyp tissue and prevent bleeding.
- Snare polypectomy: A snare is a loop that can grab and remove the polyp, and is the most popular option when the polyp is larger than 1 cm. The snare can be either hot or cold, and the surgeon may also use electrocautery to burn away any remaining polyp tissue.
During the procedure, a patient may feel pressure or pulling, but should feel no pain. Depending on the location of the polyp and other factors, a doctor may give the patient pain medication before, during, or after the procedure.
When polyps are very large, it may be necessary to remove them through an incision. This procedure is more complicated, and requires general anesthesia.
Some bleeding and pain may follow the polypectomy. Excessive bleeding, or pain that does not subside, should be brought up with a doctor.
Recovery from a polypectomy usually takes about 2 weeks. Patients may feel pain following the procedure, particularly immediately after the procedure.
Taking the pain medication the doctor prescribes can help.
It's normal to experience some bleeding following the procedure, but call the physician if the bleeding is very heavy, stops and then starts again, or has a foul odor that could indicate an infection.
After the polyp is removed, it will be sent to a lab for testing. If it's not cancerous, the patient will undergo an exam following the removal, but will likely need no further treatment.
How do you know if you need one?
Most people with polyps don't know they have them.
When they cause symptoms, a doctor may recommend screening tests. In some cases, polyps are discovered as part of screening for something else. This means that people are more likely to undergo a polypectomy when they also undergo a screening test that can detect polyps.
People who have symptoms related to their polyps, such as pain or bleeding, usually need to have the polyps removed.
Like all surgeries, they carry some risks. Those include:
- Organ perforation: This occurs when the organ being operated on is punctured. This can be fatal, but is rare.
- Excessive bleeding: Sometimes the wound does not properly heal, causing excessive bleeding.
- Infection: Any wound can become infected, and a polypectomy creates a wound. Infection is more likely when patients ignore doctor advice, or are already in poor health.
- Incomplete removal: Sometimes the first procedure leaves some tissue behind, necessitating a second polypectomy.
A polypectomy is a routine procedure that can eliminate symptoms of polyps and test for cancer. As with any procedure, patients should weigh the benefits and risks with the help of their doctor. For most polypectomy recipients, however, the procedure is a minor inconvenience that can offer peace of mind and relief from troublesome symptoms.