Standardisation of polypectomy technique

Moss, Alan; Nalankilli, Kumanan

doi:10.1016/j.bpg.2017.05.007

Cited by 19 publications

(12 citation statements)

References 42 publications

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“…6 HBF is not recommended by the USMSTF or the American Society for Gastrointestinal Endoscopy for routine polypectomy because of high rates of incomplete resection, inadequate tissue sampling for histology, and high risks of adverse events such as deep thermal injury, delayed bleeding, and perforation. 1,5,6,[53][54][55][56] However, HBF can be used for hot avulsion as an adjunctive measure to remove flat or fibrotic residual polyps. 57,58…”

Section: Biopsy Forcepsmentioning

confidence: 99%

Endoscopic polypectomy devices

et al. 2021

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Section: Biopsy Forcepsmentioning

confidence: 99%

Endoscopic polypectomy devices

et al. 2021

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“…The shift towards snare polypectomy for even diminutive polyps was reported, as the use of forceps is associated with incomplete removals of the polyp as well as higher complication rates [6]. Others trying to standardize the polypectomy technique also agree with using the snare for polyps < 10 mm [13]. It was also shown by Singh et al that during hot snare polypectomy, the electrosurgical current used included coagulation 46% of the time, a blend 46%, pure-cut 3%, and 4% varied the current [12].…”

Section: Introductionmentioning

confidence: 99%

Design of an Impedance-Controlled Hot Snare Polypectomy Device

Thornton

Choi

2019

Sensors

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This paper goes through the process of first designing a feedback system that allows for the measuring of impedance while using the hot snare polypectomy method. The electrosurgical unit used in this study was the Olympus PSD-30. After the impedance-controlled feedback system was completed, the device was tested under a range of power settings from 10 W–50 W. The test was performed ex vivo using porcine colon samples. Using the information gathered from these tests, a technique of determining the threshold of perforation and implementing a system to automatically stop the applied current from the PSD-30 was developed. The data showed that after an increase in impedance of 25% from that of the initially measured impedance, perforation ensued in the tissue samples. Using this information, the device was programmed to interrupt the PSD-30 at this threshold point. This final design was tested and proved able to automatically prevent the event of perforation from occurring, resulting in the ability to prevent serious complications.

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“…The indication for the different techniques is mainly based on the size, morphology of the lesion and on the risk of submucosal invasion. Based mainly on the European Society of Gastrointestinal Endoscopy (ESGE) consensus guideline, nowadays we have a better understanding of how to perform safe and effective polypectomy [15][16][17]. Because most "difficult" polyps are benign, endoscopic treatment should be preferred whenever possible rather than surgery.…”

Section: General Considerationsmentioning

confidence: 99%

“…Approximately 80% of all polyps recognized during colonoscopy are considered diminutive [17,20]. As diminutive colorectal polyps are at low risk for malignancy, different strategies have been proposed.…”

Section: Conventional Polypectomymentioning

confidence: 99%

The “Difficult” Colorectal Polyps and Adenomas: Practical Aspects

Herszényi¹

2018

Dig Dis

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Background: Colonoscopy is the gold standard for adenoma detection. All endoscopists who perform colonoscopy must by mandate be skilled to perform polypectomy. However, there are significant differences between endoscopists in terms of the polyp detection rate and in the effectiveness of polypectomy. Summary: Most polyps identified can be managed by conventional polypectomy and do not pose a significant challenge for resection to an adequately skilled and trained endoscopist. Up to 15% of polyps may be considered “difficult”, unsuitable for conventional endoscopic removal because of size, morphology, site, or access grade. Endoscopist-, patient- and polyp-specific viewpoints influence the management of difficult polyps. Advances in endoscopic resection techniques have led to extended indications for polypectomy. Conventional endoscopic removal of colorectal polyps is associated with a small but not negligible incidence of complications, most commonly bleeding and perforation. Advanced techniques for difficult polyps can potentially cause significant, even life-threatening complications. In addition, in the presence of “difficult” polyps, complications are more common. Key Messages: Multiple techniques are now available for the resection of difficult polyps. The endoscopist should individualize the appropriate approach for the treatment of difficult polyp in order to maximize oncological safety, efficacy and minimize complications and unnecessary surgery.

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Standardisation of polypectomy technique

Cited by 19 publications

References 42 publications

Endoscopic polypectomy devices

Endoscopic polypectomy devices

Design of an Impedance-Controlled Hot Snare Polypectomy Device

The “Difficult” Colorectal Polyps and Adenomas: Practical Aspects

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