ASGE Masterclass: Expert Performance Approach to Colonoscopy (On-Demand) | February 2026-Cold Snare Polypectomy

Video Transcription

Video Summary

The transcript is a teaching session on cold snare polypectomy, emphasizing it as the preferred technique for removing diminutive and small colon polyps (<10 mm), which make up most lesions found during colonoscopy. The speaker explains practical ways to estimate polyp size using tools such as the snare sheath (about 2.4 mm) as a reference. Evidence, including meta-analyses, shows cold snaring achieves higher complete histologic resection rates than cold forceps, even for polyps <5 mm, because it reliably captures a rim of normal tissue and avoids multi-bite limitations, edema, and bleeding that reduce completeness.<br /><br />The session highlights that polypectomy quality is variable and does not correlate with adenoma detection rate; finding polyps and removing them well are distinct skills. Key technique steps include clearing the field, positioning the polyp at 5 o’clock (relative to the colon lumen “clock face”), stabilizing the scope, keeping the sheath close, slowly closing to capture tissue, then cutting quickly. “Stalling” or snare entrapment is linked to grabbing too much tissue, under-distension, and non-dedicated snares; recommended fixes include reopening, insufflating, and regrasping rather than pulling. Participants also review a structured assessment tool and common errors such as losing polyp position during torqueing.

Asset Subtitle

Tonya Kaltenbach

Keywords

cold snare polypectomy

diminutive colon polyps

small colon polyps under 10 mm

polyp size estimation snare sheath

cold snare vs cold forceps resection

complete histologic resection rate

snare entrapment stalling management

polypectomy technique and quality assessment