Flat colonic polyps can be challenging to resect due to difficult position, unstable scope or slipping of the snare. Here we demonstrate a previously reported colonoscopic technique from Taiwan which facilitates easier placement of the snare thereby achieving en-bloc resection.Methods
A 67 year old lady presented to our institute with an altered bowel habit and was found to have a flat polyp in the sigmoid colon on colonoscopy.Results
Standard injection as per conventional endoscopic mucosal resection was initially performed. Then a suitably sized snare was selected and the snare tip was used to make a single incision with cut current lateral to the polyp. The snare tip was then anchored at the site of the incision and then the snare was slowly opened and simultaneously positioned around the polyp. Once the snare was adequately placed the polyp was resected. Histology revealed a tubulovillous adenoma with low grade dysplasia which was excised completely.Conclusions
This technique provides an easy and safe way to resect en-bloc flat, large and challenging colonic polyps.