46610 Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery

Name of the Procedure:

Anoscopy with Removal of Single Tumor, Polyp, or Other Lesion by Hot Biopsy Forceps or Bipolar Cautery

Summary

An anoscopy is a simple medical procedure used to visualize and examine the inside of the anus, rectum, and lower part of the sigmoid colon. During this procedure, a doctor may remove a single tumor, polyp, or other lesion using hot biopsy forceps or bipolar cautery techniques, which involve cutting and cauterizing the tissue simultaneously.

Purpose

The primary purpose of an anoscopy with lesion removal is to diagnose and treat abnormalities in the lower gastrointestinal tract. The goals include:

• Removing abnormal growths to prevent progression to cancer.
• Alleviating symptoms like bleeding or pain.
• Obtaining tissue samples for further pathological examination.

Indications

• Persistent rectal bleeding.
• Unexplained anal pain or discomfort.
• Presence of visible lesions or abnormal growths detected in previous examinations.
• Changes in bowel habits or unexplained anemia.
• Family history of colorectal cancer or polyps.

Preparation

• Patients may be advised to fast for a few hours before the procedure.
• A bowel preparation, such as an enema, may be needed to clear the rectal area.
• Adjustment of certain medications, especially blood thinners, may be required.
• Diagnostic tests like blood work or imaging studies might be ordered beforehand.

Procedure Description

1. Initial Setup: The patient is asked to change into a hospital gown and position themselves on the examination table.
2. Anesthesia: Local anesthesia is typically administered to numb the area.
3. Anoscopy: The anoscope, a small, tubular instrument, is gently inserted into the anus to provide a clear view of the rectal area.
4. Lesion Removal: Using hot biopsy forceps or bipolar cautery, the physician removes the lesion. These tools cut the tissue and cauterize it simultaneously to reduce bleeding.
5. Final Steps: The anoscope is carefully removed, and the area is cleaned.

Duration

The entire procedure typically takes about 20-30 minutes.

Setting

This procedure is usually performed in an outpatient clinic or a hospital's endoscopy suite.

Personnel

• Gastroenterologist or colorectal surgeon.
• Nurse or medical assistant.
• Anesthesiologist or nurse anesthetist (if sedation is required).

Risks and Complications

• Bleeding or infection at the removal site.
• Pain or discomfort post-procedure.
• Rare complications include bowel perforation or adverse reactions to anesthesia.

Benefits

• Immediate removal of abnormal growths, reducing the risk of malignancy.
• Prompt relief from symptoms like pain or bleeding.
• Accurate diagnosis through biopsy and histological examination.

Recovery

• Patients may experience mild discomfort or spotting for a few days.
• Pain relief medication can be prescribed if needed.
• Avoid straining during bowel movements and follow a high-fiber diet to ease bowel function.
• Follow-up appointment may be scheduled to review biopsy results and ensure proper healing.

Alternatives

• Monitoring lesions without removal (watchful waiting) in certain cases.
• Non-invasive treatments such as medication for symptom relief.
• More extensive surgical procedures if multiple or larger lesions are present.

Patient Experience

• Patients may feel slight pressure or discomfort during the insertion of the anoscope but local anesthesia will help minimize pain.
• Post-procedure sensations may include mild cramping or a feeling of fullness.
• Over-the-counter pain relievers and sitz baths can help manage any discomfort during recovery.