The procedure is typically performed during a colonoscopy and is tailored to the polyp’s size, type, and location:

1. Before Procedure Evaluation:
   
   • Diagnosis: Polyps are identified during a screening or diagnostic colonoscopy.
   • Preparation:
     
     • Bowel preparation involves a clear liquid diet 1–2 days prior, followed by laxatives (e.g., polyethylene glycol) to clear the colon.
     • Blood tests ensure surgical fitness; patients on blood thinners (e.g., aspirin, warfarin) may need to stop them 5–7 days prior, under medical guidance.
     • Patients are counseled on sedation, procedure risks, and post-procedure care.
2. Surgical Techniques:
   
   • Standard Endoscopic Polypectomy:
     
     • Performed under moderate sedation (e.g., midazolam, fentanyl) or light anesthesia, lasting 15–30 minutes (as part of a 30–60 minute colonoscopy).
     • A colonoscope is inserted through the anus to visualize the colon and rectum.
     • Polyps are identified and assessed for size, shape (sessile or pedunculated), and number.
     • Snare Polypectomy:
       
       • For pedunculated polyps (with a stalk), a wire loop (snare) is passed over the polyp, tightened, and an electric current (electrocautery) cuts and seals the stalk to prevent bleeding.
     • Piecemeal Resection:
       
       • For large or sessile (flat) polyps, the polyp is removed in pieces using a snare, often requiring multiple passes.
     • Cold Snare Polypectomy:
       
       • For small polyps (<5 mm), a snare removes the polyp without electrocautery, reducing bleeding risk.
     • Endoscopic Mucosal Resection (EMR):
       
       • For larger sessile polyps (1–2 cm), a saline solution is injected beneath the polyp to lift it, followed by snare removal.
       • Used to ensure complete resection and reduce recurrence.
   • Tattooing and Retrieval:
     
     • Polyps are retrieved for biopsy to assess for malignancy.
     • The site may be tattooed with ink for future surveillance if cancer risk is high.
   • The procedure is outpatient, with discharge within 1–2 hours post-sedation recovery.
3. After Procedure:
   
   • Patients are monitored for 1–2 hours for sedation recovery and complications.
   • Pathology reports analyze the polyp for type (e.g., adenomatous, hyperplastic) and dysplasia (pre-cancerous changes).
   • Follow-up colonoscopies are scheduled based on findings (e.g., 1–3 years for high-risk polyps, 5–10 years for low-risk).