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Published on March 04, 2015

Removing Large Colon Polyps without Major Surgery

Although polyps are small clusters of cells that form inside the colon, they can present big health issues if left undisturbed over time. While you may have heard that large colon polyps need to be removed during a colectomy, which requires a piece of the large intestine to be removed, there’s a new type of procedure that may replace the need for a major operation.

But first, let’s discuss what polyps are and when they should be removed.

If you’re going to take anything away from colorectal cancer awareness month, let it be this: A colonoscopy can potentially save your life and improve your health in a variety of ways.

colon poylpAlthough most colon polyps are benign—meaning they’re essentially harmless—some may become cancerous over time. As a result, you really don’t want them hanging around. “They all need to be removed, because you can’t look at a polyp and tell with certainty which will become cancer and which won’t,” said Dr. Mark Zebley, surgical director of the Gastrointestinal Procedure Unit at Abington Memorial Hospital. 

While anyone can develop polyps anywhere in their large intestine, you’re at higher risk if you’re 50 or older, or have a family history of colon polyps or colon cancer.

Since there are usually no symptoms associated with colon polyps, doctors recommend regular colon cancer screenings to identify polyps or early signs of cancer in the large intestine.

If your doctor discovers you have one or more polyps, the removal procedure will be determined based upon size. In most cases, small polyps can be removed during a colonoscopy, which is part of the colon cancer screening process. Your doctor will either snare the polyp with a wire that uses electricity to take it off or remove it with forceps if it’s really small.

Until now, polyps that are too large to be removed safely during a colonoscopy required patients to undergo a colectomy to remove them. This is a major abdominal operation that requires general anesthesia and removing a piece of the large intestine—which means there are many potential risks as a result. “The biggest risk is when we put the intestine back together,” said Dr. Zebley. “It can sometimes leak at that junction point and cause a serious infection.”

Fortunately, however, this same goal can now be accomplished without removing a piece of the colon.

The latest polyp removing procedure, ESD (Endoscopic Submucosal Dissection), allows doctors to remove the polyp without major surgery. Although the ESD procedure takes much longer than a routine colectomy, it’s a safe alternative that doesn’t sacrifice any of the colon. “We have to lift the polyp onto a ‘pillow’ which separates the polyp and the muscular layer of the colon,” said Dr. Zebley. “Once the polyp is raised onto this protective cushion, a special knife is then passed through the colonoscope and used to slowly cut the polyp out from the inside of the colon.”

To find an Abington Health physician trained in this procedure, please call 215-481-MEDI.

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