Until recently, the treatment of benign tumors located in the gastrointestinal tract was carried out only in a radical way: the patient was exposed to the abdominal cavity and resected mushroom-like benign neoplasms. Now the scalpel has been replaced by equipment that helps to produce endoscopic removal of polyps. With its use, tens of thousands of patients were relieved of the need to undergo cavitary surgery. What is the essence of the method? What are the advantages of it? What complications can be expected with an unsuccessful endoscopy? The answers in this article.
Usually, endoscopic removal of polyps is performed on an outpatient basis. The patient is injected into a state of drug sleep. A shallow anesthesia is used, so the patient is deprived of unpleasant sensations in the first minutes after the operation. Medications are administered through a vein, they have an ultrashort effect, there are almost no side effects, after 15 minutes the patient regains consciousness and leaves home alone. This time is enough to produce endoscopic removal of polyps.
There are several techniques for endoscopy:
- Electroexcision.
- Electrocoagulation.
- Photocoagulation.
- Removal of polyp by radio wave method.
The choice of technique depends on the type of polyp.
Conditionally new formations are divided into four groups:
- Polyps of the first group are similar to plaques that closely adjoin the mucosa.
- Neoplasms of the second group are oval in shape, the leg is also missing, but it is very short, the polyp is very soft to the touch. When pressing with endoscopic forceps, the object is well displaced, so it can be easily "lashed" with a special loop.
- Polyps of the third group have a round shape, wide base and large sizes.
- The latter group includes pathological substances on a long, high, thin stalk, which is well displaced in any direction.
Removal of polyps by colonoscopy
Polyps of the second and fourth group are removed by electrocoagulation. On the back of the patient in the region of the sacrum is attached an electrode - a wide lead plate. Through the biopsy channel, a colonoscope is brought to the site of the lesion, at the base of which there is a loop, it is wrapped around the head of a polyp with the help of a lasso, the loop is tightened as much as possible, a current is applied to the loop loop. Vessel sealing takes place within 2 seconds. The head bites off with forceps and is gradually removed through the biopsy channel.
Radio wave removal of polyps
This technique has been improved today. At the disposal of surgeons received equipment that helps conduct radio-wave removal of polyps. The essence of the technique is that the colonoscopy is performed not through a current, but through radio waves. The leg of the polyp is twisted and cauterized. At the same time the tissues are not torn, but neatly diverge, so post-operative bleeding happens extremely rarely.
Neoplasms of the first and third group are most easily removed by photocoagulation. In this case, a flexible laser light guide is inserted into the biopsy channel. Under the influence of infrared waves the tissues of the neoplasm are welded. Two days later, the polyp itself falls off and is excreted along with the calves in a natural way.
Please note! The described techniques are suitable only for the removal of single neoplasms, for group foci, a resistive colonoscopy is used, the removal in this case is due to excision of the affected bowel site.
Advantages of endoscopic removal of polyps
Currently, endoscopic removal of polyps is very actively used. And all because it has a number of advantages. Here are the most basic of them:
- The use of endoscopic equipment helps to minimize risks and reduce the trauma associated with open access.
- There is no risk of postoperative hernias.
- All manipulations are performed under visual control, while the anatomical position of the organs is preserved intact.
- Since there is no need for layer-by-layer dissection of the abdominal wall, the operation time is reduced to a minimum, which means that the action of anesthesia is less damaging to the body. Today, removal of the polyp by the radio-wave method occurs in just 10-15 minutes.
- The absence of large coarse seams, excellent cosmetic results.
- Lack of rehabilitation period, the fastest possible return to previous life.
- Endoscopic intervention does not require a strict diet and strict restrictions on physical activity.
Today, even for diagnostic purposes, endoscopic colonoscopy is used, removal of polyps is the second stage of treatment. The choice of the method is prompted by the morphology of pathology itself. Preferring the described techniques, it is necessary to know what complications arise after such operations.
The most common complication is the appearance of bleeding. Provoke them may lack of experience of the surgeon. Vascular coagulation during intervention should be performed with jewelry accuracy."Bust" will provoke necrosis of the intestinal wall and will invariably lead to the same mechanical resection of the intestine."Failure" will cause poor sealing of the vessels and, as a result, rupture of the commissural scab. Only an experienced surgeon can guarantee a successful outcome.