How to Do a Colonoscopic Polypectomy & U.S. COVID-19 Tracker

NPR’s website has a good tracker of what is going in each state.  Here’s the link:

NPR: Map: Tracking The Spread Of The Coronavirus In The U.S  One example: on this tracher, in Georgia, March 27, 8:30 am: 1642 reported cases, 56 deaths. (However, Georgia has conducted less than 10,000 tests in a population of more than 10 million).

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A recent review (M Kay, R Wyllie. JPGN 2020; 70: 280-4) provides some practical tips for improving polypectomy technique.

Key points:

The optimal position for the polyp is in the 5-7 o’clock position.

  • Snaring juvenile polyps close to the head rather than close to the colonic wall “allows for easier therapeutic intervention if polypectomy bleeding occurs” (eg. hemoclip) and may lower the risk of complications like perforation
  • Epinephrine volume reduction (for larger polyps) (use 1:10,000 dilution) and saline-assisted polypectomy may facilitate procedure.  Large polyps (>2 cm) could require piecemeal resection; epinephrine reduction may result in a decreased size as well.
  • “Cold snare technique has replaced use of hot biopsy forceps in adults for removal of small sessile polyps”
  • Electrosurgical units (ESUs) -settings are specific to each unit.  Newer ‘smart’ ESUs have suggested default settings, typically lower settings for right colon. “Most endoscopists use pure coagulation current or a combination of coagulation and cutting settings (blended current) for snare polypectomy. Use of pure cutting current without coagulation will result in bleeding.”

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5 thoughts on “How to Do a Colonoscopic Polypectomy & U.S. COVID-19 Tracker

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