45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

Name of the Procedure:

Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

• Common names: Colonoscopy with polyp removal, Colon Polypectomy
• Medical term: Colonoscopy with snare polypectomy

Summary

A colonoscopy with snare polypectomy is a procedure in which a flexible tube with a camera (colonoscope) is inserted into the rectum to examine the colon. During the procedure, any identified tumors, polyps, or other lesions can be removed using a snare, which is a wire loop.

Purpose

• Medical condition addressed: Detection and removal of colonic polyps, tumors, and other abnormal growths.
• Goals/Outcomes: To diagnose potential colorectal cancer or prevent it by removing precancerous growths; to relieve symptoms caused by polyps; to obtain tissue samples for further pathological examination.

Indications

• Presence of symptoms such as rectal bleeding, chronic diarrhea, or unexplained weight loss.
• Positive results from non-invasive tests (e.g., stool tests indicating blood).
• History of polyps, colorectal cancer, or significant family history.
• Screening for colorectal cancer in individuals over 45 years old or as recommended by a physician.

Preparation

• Fasting for 12 hours before the procedure.
• Bowel cleansing preparation, usually involving prescribed laxatives.
• Possible cessation or adjustment of certain medications (e.g., blood thinners, iron supplements).
• Diagnostic tests such as blood work, and sometimes, an initial consultation.

Procedure Description

1. Preparation: The patient changes into a hospital gown and receives intravenous sedation or anesthesia.
2. Insertion: The colonoscope is gently inserted into the rectum and advanced through the colon.
3. Examination: The camera on the colonoscope allows the physician to examine the lining of the colon.
4. Identification: Any tumors, polyps, or lesions are identified.
5. Removal: Using the snare technique (a wire loop), identified growths are excised or removed.
6. Conclusion: The tissue samples are collected for biopsy if necessary, and the colonoscope is withdrawn.

• Tools/equipment: Colonoscope, snare, suction devices, biopsy forceps.
• Anesthesia details: Patients typically receive either conscious sedation or general anesthesia.

Duration

The procedure typically takes between 30 to 60 minutes, depending on the findings and the number of polyps removed.

Setting

Usually performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

• Gastroenterologist or colorectal surgeon.
• Nurses to assist with the procedure and patient care.
• Anesthesiologist or nurse anesthetist, especially if general anesthesia is administered.

Risks and Complications

• Common risks: Mild cramping and bloating.
• Rare risks: Perforation of the colon, significant bleeding, infection, adverse reaction to sedation or anesthesia.
• Management: Immediate care by the medical team; hospitalization for severe complications.

Benefits

• Early detection and prevention of colorectal cancer.
• Relief from symptoms caused by polyps or other lesions.
• Diagnostic clarity through tissue biopsy. Benefits are typically realized almost immediately, with results from biopsies available within a week.

Recovery

• Patients are monitored for a few hours post-procedure to ensure stability.
• Post-procedure care includes guidance on diet (starting with clear liquids) and activity restrictions (avoid heavy lifting for a few days).
• Expected to resume normal activities within 24 to 48 hours.
• Follow-up appointments to discuss biopsy results, if applicable.

Alternatives

• Stool-based tests (limited to screening, do not allow for removal or biopsy).
• CT colonography (visualization only, without removal capability).
• Sigmoidoscopy (limited to the distal part of the colon).

Patient Experience

• During: Patients under sedation generally feel no pain; under conscious sedation, they might feel slight pressure.

• After: Possible mild cramping, bloating, and gas; typically, pain is minimal and manageable with over-the-counter pain relief.

  Comfort measures include warm blankets and reassurance from the healthcare team.