OMED Video Library - Dr. Michael Bourke from Westmead Hospital in Australia performs an endoscopic mucosal resection of a large sessile polyp at the hepatic flexure

• Dr. Michael Bourke from Westmead Hospital in Australia performs an endoscopic mucosal resection of a large sessile polyp at the hepatic flexure in a patient who is referred for this procedure since the previous doctor could not access the polyp.

Dr. Michael Bourke from Westmead Hospital in Australia performs an endoscopic mucosal resection of a large sessile polyp at the hepatic flexure in a patient who is referred for this procedure since the previous doctor could not access the polyp. Dr. Bourke injected saline with epinephrine and methylene blue into the submucosa proximal to the polyp. An attempt was made at retroflexion, but the polyp could not be well seen. Eventually, the patient was turned onto the back and the polyp changed position to a much more favorable location for polypectomy, with the polyp lying on the wall at the 5-6 o'clock position. The snare was placed over a large portion of the polyp which was resected. The remainder of the polyp was then removed with another application of the wire snare. An excellent result was achieved. The polyp turned out to be a tubulovillous adenoma. The patient had previously been scheduled for surgery, but this colonoscopic procedure safely removed the polyp and surgical treatment was not necessary.

This procedure was performed at the therapeutic endoscopy course held annually in Toronto by Dr. Norman Marcon and associates.