45338 Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

Name of the Procedure:

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

• Common Name: Flexible Sigmoidoscopy with Polypectomy
• Technical Terms: Flexible Sigmoidoscopy with Snare Polypectomy

Summary

A flexible sigmoidoscopy is a medical procedure used to examine the lower part of the colon (sigmoid colon). During this procedure, tumors, polyps, or other lesions can be removed using a snare technique, which involves using a wire loop to encircle and cut off the lesion.

Purpose

Flexible sigmoidoscopy with snare polypectomy is used to diagnose and treat abnormalities in the lower colon. Its primary goal is to remove polyps or other lesions that might be cancerous or have the potential to become cancerous, thereby preventing colorectal cancer.

Indications

• Chronic diarrhea or constipation
• Blood in the stool
• Abdominal pain
• Family history of colorectal cancer or polyps
• Monitoring of previously diagnosed polyps

Preparation

Patients may be required to:

• Follow a clear liquid diet for 24 hours prior to the procedure.
• Complete bowel preparation, which usually involves taking a prescribed laxative.
• Avoid certain medications as instructed by their healthcare provider.

Procedure Description

1. The patient lies on their side on an examination table.
2. Sedation or local anesthesia may be administered to ensure comfort.
3. A flexible sigmoidoscope is gently inserted into the anus and slowly advanced through the rectum into the sigmoid colon.
4. Air may be introduced to expand the colon for better visualization.
5. The scope transmits video images to a monitor, allowing the doctor to examine the colon.
6. If a polyp or lesion is found, a snare— a wire loop—is guided through the scope to encircle and remove it.
7. The removed tissue is usually sent to a lab for analysis.

Duration

The procedure typically takes about 15-30 minutes.

Setting

Flexible sigmoidoscopies are usually performed in outpatient clinics, hospitals, or surgical centers.

Personnel

• Gastroenterologist or Colorectal Surgeon
• Nurses
• Anesthesiologist or Sedation Specialist (if sedation is used)

Risks and Complications

• Common Risks: Mild discomfort, cramping, or bloating
• Rare Risks: Bleeding, infection, perforation of the colon, adverse reactions to sedation

Benefits

• Early detection and removal of potentially pre-cancerous polyps
• Relief from symptoms
• Improved colon health
• Immediate results (removal of detected lesions)

Recovery

• Patients are usually able to go home the same day.
• Mild discomfort or cramping may be experienced.
• Rest is recommended for the remainder of the day.
• Avoid strenuous activities and follow specific dietary instructions.
• A follow-up appointment may be needed to discuss lab results.

Alternatives

• Colonoscopy: Examines the entire colon and allows for the removal of polyps throughout the large intestine.
• CT Colonography: Uses CT scans to produce images of the colon and rectum but does not allow for removal of polyps.
• Stool tests: Non-invasive tests that can detect blood or abnormal DNA in the stool but cannot remove polyps.

Patient Experience

During the procedure, patients may feel pressure, bloating, or mild cramping. Sedation or local anesthesia helps minimize discomfort. Post-procedure, patients might experience slight bleeding or continued cramping, which usually resolves quickly. Pain management options include over-the-counter pain relievers and following dietary recommendations.