Name of the Procedure:

Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps

Summary

A flexible sigmoidoscopy with hot biopsy forceps is a procedure where a doctor uses a flexible tube with a camera to examine the lower part of your colon and rectum. During the procedure, the doctor can remove abnormal growths such as tumors, polyps, or lesions using a special tool called hot biopsy forceps which uses heat to cut and cauterize the tissue.

Purpose

This procedure is performed to:

• Detect and remove abnormal growths in the rectum and lower colon.
• Prevent potential cancer development by removing precancerous polyps.
• Diagnose causes of symptoms like bleeding, pain, or changes in bowel habits.

Indications

• Presence of symptoms like rectal bleeding, unexplained bowel habits changes, or abdominal pain.
• Detection of abnormal growths during prior screenings or imaging tests.
• Increased risk for colorectal cancer due to personal or family medical history.

Preparation

• Patients may need to follow a clear liquid diet and use a prescribed laxative to empty the colon.
• Fasting for several hours before the procedure is typically required.
• Certain medications may need to be adjusted or paused as per doctor’s guidance.
• Diagnostic tests like blood work or imaging may be performed in advance.

Procedure Description

1. The patient lies on their side on an examination table.
2. Sedation or local anesthesia may be administered to minimize discomfort.
3. A flexible sigmoidoscope (a thin, flexible tube with a camera) is gently inserted into the rectum.
4. The doctor examines the rectum and sigmoid colon via the camera feed displayed on a monitor.
5. If abnormal growths are found, hot biopsy forceps are used to remove them by applying heat to the tissue.
6. Removed tissue samples may be sent for further laboratory analysis.

Duration

The procedure typically takes about 15 to 20 minutes, with extra time for preparation and recovery.

Setting

The procedure is usually performed in a hospital outpatient department, outpatient clinic, or a surgical center.

Personnel

• Gastroenterologist or colorectal surgeon who performs the procedure.
• Nurses assisting with preparation and monitoring.
• Anesthesiologist or nurse anesthetist if sedation or anesthesia is used.

Risks and Complications

• Minor complications include bloating, gas, or mild cramping.
• Rare complications include bleeding, infection, and perforation of the colon.
• Possible adverse reactions to anesthesia or sedation.

Benefits

• Early detection and removal of potentially precancerous growths.
• Accurate diagnosis of symptoms affecting the lower gastrointestinal tract.
• Minimally invasive technique with a relatively quick recovery.

Recovery

• Patients may experience mild bloating or cramping, which typically resolve within a few hours.
• Refrain from heavy lifting or strenuous activities for 24 hours if sedated.
• Follow post-procedure dietary instructions if provided.
• A follow-up appointment may be scheduled for discussing biopsy results or further care.

Alternatives

• Colonoscopy: Examines the entire colon, but is more invasive.
• CT colonography: Non-invasive imaging test, but cannot remove polyps.
• Stool tests: Non-invasive but less precise in detecting problems in the colon.

Patient Experience

• Patients may feel slight pressure or discomfort during the procedure.
• Sedation can minimize pain and anxiety.
• Full recovery is usually quick, with patients able to resume most activities within the same day.
• Any pain or discomfort can typically be managed with over-the-counter pain relievers.