Polypectomy Surgery in Tiruchirappalli

Polypectomy is a surgical procedure to remove polyps from certain organs, such as the colon, uterus, gallbladder, or stomach. Colon polyps are the most commonly found polyps in your body which are the abnormal growth of cells that form on the inner lining of the colon (a tube-like organ connected to the small intestine at one end and the anus at the other end). These are benign (non-cancerous), flat, or raised growths that are usually harmless, but some may be pre-cancerous, which means they are not cancerous now but could turn into cancer in the future. 

Polypectomy is usually a noninvasive (does not involve extensive incisions or cuts, with quick recovery) procedure that can sometimes be performed during routine diagnostic tests like endoscopy (imaging procedure used to examine the upper digestive system visually) or colonoscopy (examination performed by the surgeon using a colonoscope to look inside your large intestines for diseases and abnormalities). Read on to explore polypectomy and how the procedure is performed.

Polypectomy is a noninvasive surgical removal of abnormal tissue growths inside any organ or body cavity known as polyps. These are benign tissues that may be seen developing within the:

• Colon
• Uterus
• Stomach
• Gallbladder

Though polyps are harmless growths, they must be removed since they could be "precancerous" and may pose a risk of developing into cancer. Colon polyps are the most common polyps that require surgical removal.

Many growths in the colon are non-cancerous (benign) but may eventually become cancerous (malignant); hence, polypectomy is recommended to prevent the growth transition from non-cancerous to cancerous. The tissues that are removed are examined, which is useful for screening and prevention of:

• Colon cancer 
• Uterus cancer
• Stomach cancer
• Gallbladder cancer 

Polypectomy may also be recommended for large polyps that cause symptoms like:

• Uncontrolled rectal bleeding during bowel movements
• Severe pain and pressure on your internal organs
• Blockage of the blood vessels, bile duct, or intestines
• Infertility and menstruation problems 

A polypectomy is recommended to help relieve these symptoms to improve your quality of life. However, polypectomy is recommended only for small polyps (< 5cm) since large, complex polyps must be surgically removed.

You will need to see a surgical gastroenterologist (a surgeon specializing in the gastrointestinal system's diseases) who will review your medical history to evaluate your symptoms like severe pain, rectal bleeding, constipation, or diarrhea. 

• You may be advised to undergo a colonoscopy (a diagnostic test conducted to detect a colon polyp and evaluate its size and exact location) using a colonoscope (a long, flexible tube-like instrument that consists of a light source and a tiny camera). Mostly during colonoscopy, the surgeon will remove the polyp (s).
• Before a colonoscopy, you must prepare yourself at least 24 to 48 hours before the test.
• You will need to undergo a thorough bowel preparation, 1 to 2 days before the colonoscopy, that may include:
  • Using a laxative- A stool softener to treat constipation
  • Having an enema- Fluids given to clean your bowels
  • A clear liquid diet -That may include broth, soups, and juices
• Arrange for someone to drive you back home after the procedure.

The polypectomy is usually done during a colonoscopy procedure. A surgical gastroenterologist performs the procedure.

• Your vitals, like blood pressure, heart rate, pulse, blood sugar, and oxygen level, will be checked before the procedure begins.
• You will be given either local or general anesthesia, depending on your condition..
• You will be made to lie on your side with your knees pulled toward your chest.
• Your doctor will insert a colonoscope through your anus, into your rectum, and the colon.
• You may feel slight pressure, but it will not hurt much. 
• Your doctor might use a gas to inflate your colon to improve visibility while performing the procedure.
• The colonoscopy will capture images of the inside of your colon and project them on the screen to guide your doctor in locating the polyp.
• Once the poly is located, polypectomy will be performed by one of the following techniques:

Snare Polypectomy

• In this technique, a thin wire (snare) will be attached to one end of the colonoscope and inserted into the colon near the location of the polyp.
• The snare loops around the polyp and generates heat that will scrape or cut off the polyp while cauterizing (a condition to halt bleeding) the wound.
• The entire polyp will be extracted through the colonoscope.
• This technique is favorable for small polyps.

Endoscopic Mucosal Resection (EMR)/ Piece-Meal Polypectomy

• This technique is used for larger polyps located in locations that pose a challenge for removal.
• A saline solution will be injected to lift the polyp from its position.
• A snare will be inserted through the colonoscope, and the polyp is extracted as a whole piece.
• The heat generated by the snare cuts off the polyp from its base.
• Once the polyp is removed, it will be sent to the pathology for a biopsy test (a diagnostic test to study the tissue under the microscope to check for malignancy (cancer forming ability).
• The procedure takes around 30 minutes to 1 hour, depending on the technique used.

Once the procedure is completed, you may have to stay in the hospital until you are completely free from the effects of anesthesia. Your vitals would be checked again to evaluate your condition.

• Once you are awake, you can go home the same day. 
• You may experience bloating due to the gas used during the procedure; hence you may need to be gentle with your digestive system. Consume easily digestible foods (white rice, bananas, toast, apple sauce, oatmeal, etc.) for the initial few days after the procedure.
• You may rest the day of your procedure and resume work the following day.
• Recovery is quick and usually takes around 2 to 3 days.

Polypectomy effectively removes polyps that may eventually enlarge in size, causing pain and discomfort and negatively impacting your quality of life. It has the following benefits and risks:

Benefits:

• It is a non-invasive method and does not involve trauma to the surrounding structures.
• It is a less time-consuming procedure.
• There are no external visible incisions (cuts) or stitches involved.
• Usually a less painful procedure.
• There is no scarring. 

Risks: 

• Recurrence of the polyp- A new polyp could develop near the surgical site.
• Incomplete Removal- Some abnormal tissues requiring a repeat procedure could be left out.
• Post-polypectomy thermal injury (PPTI)- Characterized by abdominal pain, fever, and tachycardia (increased heart rate).
• Infection- Wound infection may occur among people with pre-existing conditions like diabetes (increased blood sugar levels). Symptoms include fever, chills, and body aches.

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