GI Now for Group Practice-Basic and Advanced Polypectomy Techniques

Video Transcription

Video Summary

In this video, Dr. Michael Bourke discusses the importance of polypectomy in gastroenterology practice. He explains that polypectomy is the most common therapeutic intervention performed by gastroenterologists and endoscopists. He emphasizes the need for evidence-based techniques in polypectomy and introduces Professor Rastogi-Armit, who will discuss basic and advanced polypectomy techniques, as well as the treatment of recurrence and difficult lesions. <br /><br />The video then focuses on the technique of cold-snare polypectomy, which has seen increased use in recent years due to its high complete resection rate and safety profile. Dr. Bourke explains that cold-snare polypectomy is the preferred method for removing polyps less than or equal to 10 millimeters. He discusses the advantages of cold-snare polypectomy over hot-snare polypectomy, including similar resection rates, lower post-polypectomy bleeding rates, and shorter procedure times. He also highlights that cold-snare polypectomy has been shown to be beneficial for polyps greater than 10 millimeters, particularly in terms of reducing post-polypectomy bleeding. Dr. Bourke further explains that recent studies have shown the effectiveness and safety of cold-snare polypectomy for the treatment of serrated lesions.<br /><br />The video also touches on the technique of conventional EMR for larger polyps, highlighting the importance of lesion assessment and characterization. Dr. Bourke explains that resectability and the availability of sufficient time on the schedule should be considered before attempting a polypectomy. He demonstrates the technique of EMR, including injection, snaring, and resection. He also discusses the use of clips for closing the post-EMR defect in larger polyps, especially those in the right colon, to prevent post-polypectomy bleeding.<br /><br />The video concludes by addressing complications of polypectomy, including bleeding and perforation. Dr. Bourke emphasizes the importance of managing these complications effectively and demonstrates techniques for controlling bleeding and closing perforations using clips. He also discusses the need for proper follow-up and surveillance colonoscopy after polypectomy, as well as the role of tattooing in identifying the site for future reference or guiding the surgeon in case of referral for surgery.<br /><br />The video provides valuable insights into the techniques and considerations involved in polypectomy, emphasizing evidence-based practices and the importance of proper management of complications and follow-up care.

Asset Subtitle

Amit Rastogi, MD, FASGE

Keywords

polypectomy

gastroenterology

therapeutic intervention

endoscopists

cold-snare polypectomy

hot-snare polypectomy

post-polypectomy bleeding

serrated lesions

conventional EMR

follow-up care