David G. Hewett, MBBS, MSc, PhD, FRACP Gastrointestinal Endoscopy

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Presentation transcript:

Cold snare polypectomy: optimizing technique and technology (with videos) David G. Hewett, MBBS, MSc, PhD, FRACP Gastrointestinal Endoscopy Volume 82, Issue 4, Pages 693-696 (October 2015) DOI: 10.1016/j.gie.2015.04.028 Copyright © 2015 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 The technique of cold snaring. A, Detect. A diminutive polyp in the proximal colon. B, Characterize. Image enhancement with narrow-band imaging and optical magnification shows an adenoma. C, Align and measure. The polyp is aligned with the instrument channel, and the snare catheter tip is used to measure the lesion size (2 mm). D, Open. The snare (Exacto; US Endoscopy, Mentor, Ohio) is opened and positioned to capture the lesion and a margin of normal tissue. E, Anchor. The catheter is advanced while the instrument tip is angled down and to the right. F, Close and cut. The snare is closed continuously to transect the tissue. G, Retrieve. When the catheter is anchored to the colon wall during snare closure, the lesion remains within the defect for easy suction. H, Inspect. The defect is inspected to ensure complete resection and absence of bleeding (minor bleeding is typical). Gastrointestinal Endoscopy 2015 82, 693-696DOI: (10.1016/j.gie.2015.04.028) Copyright © 2015 American Society for Gastrointestinal Endoscopy Terms and Conditions