Complicated Polypectomy

Jerome D. Waye, Yasushi Sano

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Before beginning polypectomy, the polyp should be evaluated for the possible presence of malignancy. Approaching the large and difficult colon polyp requires skill and patience. Properly trained endoscopic assistants must be present as well as all necessary equipment including the electrosurgical unit and a variety of ancillary therapeutic devices. Two major techniques that are used for removal of the difficult colon polyp are endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). EMR requires the repeated application of standard techniques ordinarily used for polypectomy, including submucosal injection and piecemeal resection of adenomatous tissue. ESD on the other hand involves electrocautery tunneling underneath the entire polyp with special tools, resulting in one large specimen. Both methods are effective for removal of sessile polyps. The technique of EMR is within the capability of any person who has learned the basic techniques of polypectomy since removal of large sessile neoplasms is only an extension of the skills requires to resect smaller polyps. ESD is a new and exciting development in the field of colon polypectomy where developments and tools and techniques are progressing rapidly.

Original languageEnglish
Title of host publicationSuccessful Training in Gastrointestinal Endoscopy
Number of pages15
ISBN (Print)9781405196635
StatePublished - 26 Apr 2011


  • Competency
  • Complex polypectomy
  • Complicated polypectomy
  • Endoscopic mucosal resection (EMR)
  • Endoscopic submucosal dissection (ESD)
  • Large colon polyps
  • Learning
  • Piecemeal polypectomy
  • Removing the difficult polyp
  • Teaching
  • Training
  • Training for complex polypectomy
  • Training for complicated polypectomy
  • Training for polypectomy


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