Definition & Overview
Polypectomy is the surgical procedure of removing polyps from different parts of the body usually in the colon or large intestine, cervix, uterus, and nasal cavity. In rare cases, it is also performed to remove abnormal growths outside the ear canals (aural polyps).
A polyp is an abnormal tissue growth that is often benign (noncancerous) and can form in any part of the body where there are blood vessels. The most common types are those found in the cervix (cervical polyps), large intestine (colonic polyps), sinuses (nasal polyps), stomach lining (gastric polyps), and along the lining of the uterus (uterine polyp).
The procedure is typically performed in conjunction with a biopsy to determine if the growths are benign (non-cancerous) or malignant (cancerous) so further treatment can be planned if needed. The decision to perform polypectomy usually depends on several factors, including the number and size of polyps found, whether or not they are malignant, and their location. Other factors considered are patient’s lifestyle habits such as smoking or substance abuse, as well the presence of blood-clotting and chronic disorders that can complicate the procedure.
Who Should Undergo and Expected Results
As mentioned earlier, the procedure is performed to remove cervical, colonic, nasal polyps, gastric, uterine, and sometimes, aural polyps.
Cervical and uterine polyps – Although most cases of these polyp growths are benign, doctors still recommend polypectomy as there's a possibility for these tissues to became cancerous. As such, the procedure is performed as a preventative measure. Cervical polyps do not cause any symptoms and can only be detected through several different tests and examinations.
Colon or gastric polyps. The removal of colon or gastric polyps treats the condition’s common symptoms including abdominal pain, bleeding from the rectum, and irregular bowel movements. It also halts the development of colon cancer.
Nasal polyps. A polypectomy can help relieve symptoms of blocked nasal airway and sinuses as well as chronic sinusitis, asthma, allergies, or persistent cold symptoms.
Aural polyps – In rare cases, patients develop a polyp outside their ear canals, which is often caused by a cyst, tumor, or foreign objects. Polypectomy can be recommended to prevent hearing loss and stop bleeding from the ear.
Polypectomy is considered a simple, minimally invasive procedure with high success rate and minimal complications.
How is the Procedure Performed?
Depending on the location where polypectomy is done, the surgeon may administer anesthesia to sedate the patient. However, in the case of cervical polypectomy, anesthesia is usually not needed, as the procedure is typically painless.
During cervical polypectomy, a speculum is inserted into the vagina to expose the cervix. Small blunt forceps are then used to grab and twist the polyps one by one until they are completely separated from their bases. The polyps are then collected and samples sent to pathologists for a biopsy. The whole procedure is relatively painless, though there are cases when the polyps are too large that the surgeon may decide to place the patient under anesthesia to avoid pain or discomfort.
To perform colon or rectal polypectomy, a long, flexible tube with a camera at the end, called an endoscope, is inserted through the anus so the surgeon can locate the polyp without making large incisions. In some cases, a special type of liquid is used in the lining of the bowel to lift off the polyps and make them easier to locate. A snare or a wire lasso is then looped around the base of the polyp and an electric current is passed through the snare to cauterize the polyp as well as any blood vessel connected to it to avoid bleeding.
The same technique is applied in performing nasal polypectomy, except for the use of cautery. A great deal of care is taken not to harm any nearby blood vessels, orbit, or the skull base.
Possible Risks and Complications
Just like any type of medical procedure, polypectomy comes with some risks, including:
- Adverse reactions to the anesthesia used
- Heavy bleeding, for those who have undergone cervical polypectomy and those who had polyps removed from the colon or stomach
- Damage or perforation to the large intestine wall (for polypectomy in the colon), possibly leading to bleeding or infection.
Deyhle P (1980). "Results of endoscopic polypectomy in the gastrointestinal tract". Endoscopy (Suppl): 35–46.
Sternberg, Stephen S.; Stacey E. Mills; Darryl Carter (2004). Sternberg's Diagnostic Surgical Pathology. Lippincott Williams & Wilkins. p. 2460.