Technique of colonoscopic polypectomy.

Most colonic polyps can be removed colonoscopically from all reaches of the colon, provided that one is experienced with endoscopic morphology and snare electrosurgical techniques. Virtually all pedunculated polyps and the majority of benign sessile polyps can be excised colonoscopically, certain of the larger benign sessile polyps and all malignant sessile lesions still require partial colectomy, if the patient's general condition will permit. Preparation for colonoscopic polypectomy includes thorough mental as well as physical preparation of the patient and the availability of properly functioning endoscopic and snare-cautery equipment. An experienced colonoscopist is one who is not only prepared for the diagnostic possibilities but experienced enough to manage certain of the larger polyps so that laparotomy is limited to those few lesions that are not amenable to safe and total colonoscopic polypectomy.