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Rectal or Colon Polyp Removal (Polypectomy)

Article
Digestive Health
Surgical Procedures
Contributed byMaulik P. Purohit MD MPHMay 06, 2019

Background Information:

What are the other Names for the Procedure?

  • Colorectal Polyp Removal
  • Snare Polypectomy
  • Surgery for Rectal or Colon Polyp

What is Rectal or Colon Polyp Removal surgical procedure?

Rectal or Colon Polyp Removal is a procedure that involves the removal of an abnormal tissue growth from the membrane lining within the rectum or colon.

What part of the Body does the Procedure involve?

A Rectal or Colon Polyp Removal procedure involves the rectum and colon membrane lining.

Why is the Rectal or Colon Polyp Removal surgical procedure Performed?

The Rectal or Colon Polyp Removal procedure is performed for the following reasons:

  • Removal of suspected cancerous tumor
  • Removal of abnormal tissue, which is then sent to a pathologist for examination
  • Repairing abnormal rectal bleeding

What are some Alternative Choices for the Procedure?

  • A colonoscopy may be used to remove many small and moderately sized polyps found in the colon and rectum
  • A colectomy, which is a surgical procedure, may be used to remove a portion of the colon, in case the polyps are diagnosed as cancerous

What are the Recent Advances in the Procedure?

Some of the surgical procedures for Colorectal Polyp Removal used have undergone further refinement.

What is the Cost of performing the Rectal or Colon Polyp Removal surgical procedure?

The cost of a Rectal or Colon Polyp Removal procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding an Rectal or Colon Polyp Removal procedure and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

Prior to Rectal or Colon Polyp Removal surgical procedure:

How is the Rectal or Colon Polyp Removal surgical procedure Performed?

A Rectal or Colon Polyp Removal procedure may be performed under sedation.

  • After making the individual lie on his/her side with their knees drawn towards the abdomen, the surgeon inserts a scope(tube fitted with camera) into the anus and rectum to visualize the large intestine
  • The small polyps are then removed (polypectomy) by using a snare made of wire and electric current
  • The larger polyps may be removed using laparoscopic surgery. Small incisions are made on the abdomen to introduce a tube fitted with a camera and surgical instruments to perform the procedure

Where is the Procedure Performed?

A Rectal or Colon Polyp Removal procedure is usually performed in an out-patient surgery center facility, a physician’s clinic/office, or a hospital.

Who Performs the Procedure?

The Rectal or Colon Polypectomy procedure is performed by any of the following medical personnel, with or without assistance from an anesthesiologist:

  • General surgeon
  • Colon-rectal surgeon
  • Gastroenterologist
  • Family doctor

How long will the Procedure take?

The procedure may take anywhere between 30 minutes to an hour.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Rectal or Colon Polyp Removal procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for the Rectal or Colon Polyp Removal procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Rectal or Colon Polyp Removal surgical procedure?

Before a Rectal or Colon Polyp Removal procedure, the patient has to undergo certain tests such as:

  • Routine blood and urine analysis
  • X-ray of the lower gastrointestinal tract
  • Sigmoidoscopy
  • Colonoscopy

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is Rectal or Colon Polyp Removal?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
  • What are the costs involved?

During the Rectal or Colon Polyp Removal surgical procedure:

What kind of Anesthesia is given, during the Procedure?

An intravenous sedative and narcotic painkiller is administered prior to the procedure.

How much Blood will you lose, during the Procedure?

There is hardly any blood loss during an uncomplicated polyp removal (polypectomy) procedure.

What are the possible Risks and Complications during the Rectal or Colon Polyp Removal surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

  • Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
  • Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders and chronic infections
  • Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Rectal or Colon Polyp Removal surgery are:

  • Excessive bleeding
  • Infection of the surgical wound
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Rectal or Colon Polyp Removal surgical procedure?

After the surgical procedure, the patients will be sent to an area of the hospital for observation. Patients are usually released on the same day, if there are no complications observed.

After the Rectal or Colon Polyp Removal surgical procedure:

What are the possible Risks and Complications after the Rectal or Colon Polyp Removal surgical procedure?

The possible risks and complications that may arise after Rectal or Colon Polyp Removal are:

  • Excessive bleeding from the surgical wound
  • Signs of an infection resulting from an accidental colon perforation

What is the Prognosis after the Surgery?

A complete recovery from a Rectal or Colon Polyp Removal surgical procedure is usually achieved. The prognosis is excellent without any serious complications being noted.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Worsening pain and swelling of the surgical wound
  • Bleeding or fluid drainage from the surgical wound
  • The occurrence of any symptom that causes uneasiness such as nausea, vomiting, constipation, or abdominal swelling
  • Experiencing difficultly or pain while urinating
  • Accelerated pulse when standing, which may be a symptom of internal bleeding
  • Signs of an infection
  • Headache, muscle aches
  • Fever, feeling sick, weakness
  • Dizziness
  • Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Rectal or Colon Polyp Removal surgical procedure?

At home, the following post-operative care is recommended, after a Rectal or Colon Polyp Removal procedure:

  • Slowly resume regular/daily activities as early as possible, which aids in faster recovery
  • Do contact the physician if you notice an urine discoloration after first bowel movements
  • Complete the course of prescribed medication as advised by your physician
  • Take stool softeners to prevent constipation, under advice of the physician
  • Take antibiotic medication to help combat or prevent infection, per your physician’s advice
  • Avoid taking nonprescription medications such as aspirin. However, individuals may take acetaminophen to relieve pain (per the physician’s advice)
  • Avoid all activities that are physically strenuous for about 4 weeks after the surgery
  • Resume driving 3 days after being discharged from the hospital (or follow your physician’s advice)
  • Individuals are advised to have to clear liquids immediately after surgery, until the gastrointestinal tract begins properly functioning.  They may then proceed to eat a well-balanced diet, which can aid in a faster recovery.  However, fluids or spicy foods that may worsen the symptoms should be avoided

How long does it normally take to fully recover, from the Procedure?

It usually takes approximately 2-3 weeks to fully recover from the Rectal or Colon Polyp Removal procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed, as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • The slide(s) are prepared once the tissue is processed, and this is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Rectal or Colon Polyp Removal surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • An out-patient surgery center facility, a physician’s clinic/office, or a hospital
  • A general surgeon, colorectal surgeon, gastroenterologist, or a family doctor
  • An anesthesiologist (if anesthesia was administered)
  • A pathologist

The patient is advised to inquire and confirm the type of billing, before the Rectal or Colon Polyp Removal procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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