Best Polypectomy Surgery​ in Hyderabad, India | Procedure & Cost

Proper preoperative preparation of the patient is important to make sure that the procedure is safe and effective in the patient. This preoperative steps required may differ based on the polyp type being removed and its location in the body.

Pre-Procedure Assessment

• Prior to the polypectomy procedure, patients might undergo a thorough medical checkup to estimate their overall health status and eligibility for the polypectomy procedure. The evaluation includes the details below:
• A detailed medical history, including any previous polypectomies, history of gastrointestinal disorders, or past surgeries.
• A review of family history, particularly regarding colorectal cancer, gastric cancer, or hereditary polyposis syndromes.
• A list of current medications, especially anticoagulants, antiplatelets, NSAIDs, and diabetic medications, which may require temporary adjustments.
• Assessment for allergies, particularly to anesthetic agents or contrast dyes.

Bowel Preparation (For Colorectal and Gastric Polypectomy)

For polyps in the colon or stomach, patients are required to undergo bowel cleansing to ensure clear visualization during the procedure. This typically includes:

• A liquid diet (clear fluids only) for 24–48 hours before the procedure.
• Administration of laxatives or bowel cleansing agents such as polyethylene glycol (PEG) solutions to clear the colon.
• Fasting for 6–12 hours before the procedure to minimize the risk of aspiration during sedation.

Medication Adjustments

Certain medications may increase the risk of bleeding or interact with anesthesia. Therefore, physicians may recommend:

• Temporarily stopping blood thinners with appropriate bridging therapy, if necessary.
• Adjusting diabetic medications to prevent hypoglycemia, especially if fasting is required.
• Avoiding NSAIDs and herbal supplements that may contribute to increased bleeding risk.

Consent and Counseling

Before the procedure, the physician explains:

• The reason for the polypectomy and its potential benefits.
• The risks involved, including bleeding, infection, and perforation.
• Possible alternative treatments if polypectomy is not advisable.
• The need for histopathological examination of the removed polyp to assess for malignancy.
• Post-procedure recovery expectations and follow-up requirements.

Patients are required to provide informed consent before the procedure can proceed.

The detailed procedure of polypectomy upon the completion of preoperative assessment is as mentioned below:

Patient Positioning

The patient is positioned according to the site of the polyp:

• Left lateral position for colorectal polypectomy during a colonoscopy.
• Supine position for gastric or uterine polypectomy.
• Semi-reclined position for nasal polypectomy using an endoscope.

Sedation or Anesthesia

Depending on the complexity of the procedure, different levels of sedation may be used:

• Local anesthesia for nasal or minor gastrointestinal polypectomies.
• Conscious sedation (e.g., midazolam, fentanyl) for colorectal and gastric polypectomy.
• General anesthesia for extensive procedures or in cases where patient cooperation is difficult.

Insertion of the Endoscope

A flexible endoscope is introduced into the targeted area:

• Colonoscope for colorectal polyps.
• Gastroscope for gastric polyps.
• Hysteroscope for uterine polyps.
• Nasal endoscope for nasal polypectomy.

The endoscope provides high-definition visualization of the polyp and the surrounding tissue.

Polyp Removal Technique

The suitable technique is selected based on the size, location, and morphology of the polyp:

• Cold forceps or snare for small polyps (<10 mm).
• Hot snare polypectomy for larger polyps (>10 mm), with electrocautery to reduce bleeding.
• Endoscopic mucosal resection (EMR) for sessile or flat polyps, using fluid injection to lift the polyp.
• Endoscopic submucosal dissection (ESD) for deep or complex polyps, ensuring complete removal.

Hemostasis Management

To prevent or control bleeding, various hemostatic techniques may be employed, such as:

• Electrocautery (coagulation mode) to cauterize blood vessels.
• Endoscopic clips to close any visible blood vessels.
• Hemostatic sprays or gels in cases of persistent bleeding.

Specimen Retrieval and Histopathology

The removed polyp is collected using retrieval baskets, suction, or endoscopic nets and sent to the laboratory for histopathological examination. This helps determine whether the polyp is benign, precancerous, or malignant.

Upon successful completion of the procedure, postoperative care includes the following:

Post-Procedure Monitoring

After the procedure, the patient is monitored for any immediate complications, including:

• Bleeding, which may require additional hemostatic measures.
• Perforation, which, although rare, may require surgical intervention.
• Sedation-related effects, such as dizziness or nausea.
• Most patients are discharged within a few hours, unless complications arise.

Dietary Recommendations

After polypectomy, dietary guidelines depend on the site of the procedure:

• Colorectal or gastric polypectomy: A soft diet is recommended initially, avoiding spicy, fatty, and high-fiber foods for 24–48 hours.
• Uterine or nasal polypectomy: No specific dietary restrictions, but adequate hydration is advised.

Activity Restrictions

Patients should avoid strenuous activities, heavy weightlifting, and excessive bending for at least 24–48 hours after the procedure to reduce the risk of bleeding or strain on the operated site.

Follow-Up Appointments

Follow-up is essential to:

• Review the histopathology report to determine if further treatment is needed.
• Plan for repeat surveillance endoscopy/colonoscopy based on polyp type and patient risk factors.
• Assess for symptom recurrence or complications.

Warning Signs to Report

Patients are instructed to seek medical attention if they experience:

• Severe or persistent abdominal pain.
• Excessive rectal bleeding or melena (black, tarry stools).
• High fever or chills, indicating possible infection.
• Dizziness or fainting, suggestive of blood loss.
  

Advantages of Polypectomy

Some of the major benefits of the polypectomy procedure are as mentioned below:

• Cancer Prevention: Polypectomy helps in removing precancerous polyps, significantly reducing the risk of colorectal, gastric, or uterine cancer.

• Minimally Invasive: As the polypectomy procedure is minimally invasive, it avoids open surgery while achieving effective polyp removal.

• Quick Recovery: Post-procedure, most of the patients return to normal activities within 24–48 hours.

• Improved Symptoms: Polypectomy helps in resolving issues like rectal bleeding, nasal obstruction, or abnormal uterine bleeding.

• Accurate Diagnosis: This procedure enables histopathological analysis to detect malignancies early.

While polypectomy is generally safe, complications can occur:

• Bleeding: The polypectomy procedure can sometimes lead to bleeding that can be immediate or delayed, often controlled with endoscopic interventions.



• Perforation: Perforation is very rare but serious, especially in large polyp resections, sometimes requiring surgical repair.

• Infection: Infection can occur occasionally at the removal site, necessitating antibiotic treatment.

• Post-Polypectomy Syndrome: This is a rare condition causing fever and localized inflammation due to mucosal injury.

• Incomplete Resection: Some polyps may require repeat procedures for complete removal.
  

Life After the Polypectomy Procedure

• Recovery: Most patients experience mild bloating or discomfort but recover quickly.



• Dietary Adjustments: Patients recovering from colorectal polypectomy should consume fiber-rich foods and stay hydrated.

• Regular Screening: Follow-up colonoscopy or endoscopy is advised based on polyp type and recurrence risk.

• Lifestyle Modifications: A healthy diet, regular exercise, and avoiding smoking/alcohol can help prevent polyp recurrence.

Are all polyps cancerous or dangerous?

Not all polyps are cancerous. Some remain benign, while others may be precancerous or malignant. Larger, irregular, or villous polyps have a higher risk of cancer. Regular screening and histopathological examination help determine whether a polyp requires further medical attention.

Polyps are detected using colonoscopy, endoscopy, hysteroscopy, or nasal endoscopy. Additional imaging techniques like CT colonography or MRI may be used when direct visualization is not feasible. These techniques help identify polyps early, ensuring timely removal and reducing cancer risks.

Is polypectomy painful?

Polypectomy is usually painless, as it’s performed under local anesthesia, conscious sedation, or general anesthesia. Some patients may experience mild bloating, cramping, or soreness, but these symptoms are temporary and can be managed with simple pain relievers if needed.

How long does a polypectomy procedure take?

The duration depends on polyp size and location. Small polyps take 5–10 minutes, medium-sized ones take 10–20 minutes, and larger or complex polyps may take up to 60 minutes. Advanced techniques like EMR or ESD may require more time for complete removal.

Do I need to stay overnight in the hospital after a polypectomy?

Polypectomy is usually an outpatient procedure, and most patients go home the same day. However, overnight observation may be required for large polyp removal, bleeding complications, or patients with pre-existing health conditions requiring close monitoring.

What should I eat after a polypectomy?

For colorectal or gastric polypectomy, a soft, low-fiber diet is recommended for 24–48 hours. Avoid spicy, fried, or high-fiber foods. After uterine or nasal polypectomy, normal eating can resume, though avoiding irritants is advised for comfort.

When should I get my next colonoscopy or endoscopy after a polypectomy?

Follow-up depends on polyp type, size, and pathology. Precancerous polyps require repeat colonoscopy in 3–5 years, while benign polyps may only need surveillance every 5–10 years. Your doctor will recommend an appropriate screening interval.

What happens if a polyp is found to be cancerous after removal?

If a polyp is cancerous, further evaluation is needed to determine if additional surgery, chemotherapy, or radiation is required. In some cases, complete polyp removal is curative, but advanced cases may need more treatment.

Can I take my regular medications after a polypectomy?

Most medications can be resumed immediately. However, blood thinners (e.g., warfarin, aspirin) may need temporary discontinuation to reduce bleeding risk. Always consult your doctor before restarting medications, especially if taking anticoagulants or diabetes medications.

Can pregnant women undergo a polypectomy?

Polypectomy can be safely performed during pregnancy if necessary, such as for symptomatic or suspicious polyps. However, elective procedures are often delayed until after delivery, unless they pose an immediate health risk to the mother or the baby.

How should I prepare for a polypectomy?

Preparation depends on the polyp’s location. For colorectal polypectomy, bowel cleansing with laxatives or enemas is required. Patients may also need to fast for 6–12 hours and adjust medications like blood thinners or diabetes drugs before the procedure.

Is sedation required for a polypectomy?

Sedation is commonly used for comfort and relaxation. Colonoscopy and gastric polypectomy often require conscious or deep sedation, while uterine and nasal polypectomy may be performed with local anesthesia or mild sedation, depending on the complexity.

Can polypectomy cause long-term digestive problems?

Polypectomy rarely causes long-term digestive issues. Some patients experience temporary bloating, mild cramping, or altered bowel habits, which resolve within a few days. Rare complications like scarring or incomplete removal may require further evaluation or treatment.

Can I drive myself home after a polypectomy?

No, due to sedation effects like drowsiness and impaired judgment, patients should arrange for someone to drive them home. It’s advised to avoid driving, operating machinery, or making important decisions for at least 24-hour post-procedure.

What are the symptoms of complications after a polypectomy?

Warning signs include severe abdominal pain, persistent bleeding, fever, dizziness, vomiting, or black stools. These may indicate bleeding, infection, perforation, or post-polypectomy syndrome. Seek immediate medical attention if any of these symptoms occur.