Interview Questions for Polypectomy

Polypectomy techniques are categorized primarily by the method of polyp removal and the tools used. The most common methods are snare polypectomy, hot biopsy forceps polypectomy, and cold biopsy forceps polypectomy.

• Snare Polypectomy: This is the gold standard for most polyps, especially larger ones. A wire snare loop is placed around the polyp’s base, and then a current is applied to cut it off. This is usually done with diathermy (electrocautery). We carefully control the current to minimize bleeding and perforation. Think of it like using a lasso to carefully remove a growth.
• Hot Biopsy Forceps Polypectomy: Smaller polyps can be removed using hot biopsy forceps. These forceps are heated using diathermy, cauterizing the tissue as it’s removed. This method is quick and less complex for very small polyps.
• Cold Biopsy Forceps Polypectomy: This technique utilizes cold forceps for polyp removal without the application of heat. While suitable for very small and superficial lesions, it’s less effective than hot biopsy or snare polypectomy due to an increased risk of incomplete resection.

The choice of technique depends heavily on the polyp’s size, location, and morphology. For instance, a large pedunculated polyp in the rectum might be best removed with snare polypectomy, whereas a small sessile polyp in the cecum might be appropriately managed using hot biopsy forceps.

Indications for polypectomy largely revolve around the removal of colonic polyps to prevent colorectal cancer. We remove polyps because they have the potential to become cancerous. Size and histological appearance play a key role.

• Indications: Any polyp larger than 1cm, polyps with features suggestive of malignancy on imaging or biopsy (e.g., villous morphology, high-grade dysplasia), and all adenomatous polyps, regardless of size, require removal. We also remove polyps showing signs of bleeding or inflammation that cause concerning symptoms.
• Contraindications: Absolute contraindications are rare. However, severe active inflammatory bowel disease, uncorrected coagulopathy, and severe cardiovascular instability are relative contraindications that require careful consideration and often involve delaying the procedure until these conditions are better controlled.

For example, a patient with a 1.5cm polyp on colonoscopy, even without histological confirmation, would be a strong candidate for polypectomy due to the increased risk of cancer development in polyps of that size.

While generally safe, polypectomy carries several potential risks and complications:

• Bleeding: This is the most common complication. It can range from minor oozing that resolves spontaneously to significant hemorrhage requiring intervention. The risk increases with polyp size and location.
• Perforation: A hole in the bowel wall can occur, particularly with larger or difficult-to-remove polyps. This is a serious complication that may necessitate surgery.
• Infection: Rarely, infection can occur at the polypectomy site, especially if there’s incomplete resection or injury to the bowel wall.
• Incomplete Resection: This means not all of the polyp has been removed. It necessitates follow-up colonoscopy to ensure complete resection or to treat residual polyp tissue.
• Electrocution: While rare with modern equipment, electrocution can occur. This is why we take careful precautions with the equipment and patient monitoring.

These risks are minimized through careful patient selection, appropriate technique, and diligent monitoring during and after the procedure. For instance, large polyps are approached differently to minimize the risk of perforation.

Selecting the right technique is crucial for optimal results. We consider several factors:

• Polyp Size and Shape: Small, sessile polyps (flat, lying close to the bowel wall) may be removed using hot biopsy forceps. Larger, pedunculated polyps (on a stalk) are better suited for snare polypectomy.
• Location: The polyp’s location within the colon influences the choice of technique. Access to the polyp can be challenging in some locations, requiring more specialized tools or techniques.
• Patient Factors: Coagulation status, bowel preparation, and other factors relating to patient health influence decisions. A patient with a history of significant bleeding might require a more conservative approach.
• Experience and Expertise: The physician’s experience in handling different techniques also plays a significant role in determining the best approach.

For example, a large, pedunculated polyp in the sigmoid colon would necessitate snare polypectomy, given its size and accessibility. However, a small, flat polyp in the cecum might be safely removed with hot biopsy forceps.

Bleeding management is an integral part of polypectomy. Our approach is multi-pronged and depends on the severity of the bleed.

• Prevention: Proper technique, including careful snare application and appropriate energy settings, is crucial to prevent excessive bleeding. We utilize epinephrine (adrenaline) injection in certain cases to help constrict blood vessels around the polyp before removal.
• During Bleeding: If bleeding occurs, we first attempt to control it by applying pressure with forceps, or by using diathermy to coagulate bleeding vessels. We might use clips or other hemostatic techniques if necessary.
• Post-polypectomy: We closely monitor for bleeding after the procedure, usually for a short period of observation post-procedure. Patients are instructed on signs and symptoms of bleeding and the importance of seeking immediate medical attention if needed.

For instance, a slow bleed that can be easily stopped with diathermy might require only brief post-procedure observation. However, profuse bleeding might necessitate more aggressive intervention, such as injection of epinephrine or surgical repair.

Assessing the completeness of resection is crucial to prevent recurrence and the need for further procedures. Several strategies are employed:

• Visual Inspection: Careful visual inspection of the resected specimen is performed to ensure that the base of the polyp is intact and that there is no residual polyp tissue.
• Pathological Examination: The removed polyp is sent for histopathological examination to confirm the diagnosis, assess the presence of dysplasia (precancerous changes) or malignancy, and determine the adequacy of resection. Margins are carefully assessed by the pathologist.
• Endoscopic Evaluation: After polypectomy, the site is carefully inspected endoscopically to assess for any residual tissue or evidence of incomplete resection.

For example, if the pathological report indicates incomplete resection, a follow-up colonoscopy might be scheduled to address any residual polyp tissue. Careful assessment at all stages is key.

Post-polypectomy instructions focus on monitoring for complications and ensuring patient recovery. These typically include:

• Dietary Recommendations: A clear liquid diet for the first few hours after the procedure, followed by a gradual transition to a regular diet. This is to prevent straining or irritating the bowel.
• Bowel Movements: Advice on avoiding straining during bowel movements, and possibly including fiber supplementation to promote regular bowel habits.
• Medication: Information on any prescribed pain relief or bowel preparation medications.
• Follow-up: Specific instructions for scheduling a follow-up colonoscopy, as required by the results of the pathology report. It may be in a few months or years depending on the results.
• Signs and Symptoms to Watch For: Explicit instructions on recognizing and reporting signs of bleeding, fever, significant abdominal pain, or other complications.

Each patient’s instructions are tailored to their specific circumstances and the findings from the polypectomy. We empower patients to proactively monitor their recovery and seek attention promptly should any problems arise.

Handling large or difficult polyps during polypectomy requires a strategic approach combining technique and technology. Size and location significantly influence the procedure. For example, a large polyp near the cecum might necessitate piecemeal resection, where the polyp is removed in sections using snare polypectomy, ensuring complete removal while minimizing the risk of perforation. If the polyp is sessile (flat, not on a stalk), endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) might be preferred to achieve en-bloc resection. In cases of very large polyps or those with high risk features (e.g., those suggestive of malignancy), it may be safer and more effective to refer the patient for surgical resection. During piecemeal resection, it is crucial to use careful coagulation techniques to minimize bleeding and ensure complete removal of the polyp.

Strategies for difficult polyps:

• Piecemeal resection with snare polypectomy: This involves using a snare to remove the polyp in smaller pieces.
• Endoscopic mucosal resection (EMR): This technique involves injecting submucosal saline to elevate the polyp before resection.
• Endoscopic submucosal dissection (ESD): A more advanced technique used for larger, flatter polyps, involving a wider resection of the submucosa.
• Argon plasma coagulation (APC): Useful for hemostasis and reducing the polyp size before snare resection.
• Combination of techniques: Often, a combination of techniques is used to optimally manage a challenging polyp.

Example: Imagine a 3cm sessile polyp in the sigmoid colon. Attempting snare polypectomy alone might lead to incomplete resection or perforation. Therefore, EMR with injection of submucosal saline to elevate the polyp followed by snare resection would be a safer and more effective approach. Post-procedure, careful hemostasis must be ensured to avoid post-polypectomy bleeding.

Endoscopic mucosal resection (EMR) is a crucial technique in polypectomy, particularly for larger or flat polyps that are difficult to remove using conventional snare polypectomy. EMR involves injecting a solution (usually saline) beneath the polyp’s mucosa, elevating it from the underlying submucosa. This creates a cushion, facilitating easier and safer resection with a specialized EMR snare. It reduces the risk of perforation and allows for en bloc (removal in one piece) resection, crucial for accurate pathological examination. The procedure usually involves multiple steps to ensure complete resection, and the removed tissue is sent for histopathological analysis.

Key steps in EMR:

• Submucosal injection: Injecting fluid to elevate the polyp.
• Resection: Using a specialized EMR snare to remove the elevated polyp.
• Hemostasis: Applying coagulation or clips to control any bleeding.

Example: A large, flat adenoma in the cecum is best approached using EMR. The submucosal injection helps lift the lesion, enabling complete and safer resection. Without EMR, attempting snare polypectomy could lead to incomplete removal or perforation, potentially leaving behind malignant tissue and increasing complications.

Argon plasma coagulation (APC) is a non-contact energy-based modality used in endoscopy to achieve hemostasis (stop bleeding) and to ablate (destroy) tissue. In polypectomy, APC plays a vital role in several scenarios. It can be used to control bleeding during polypectomy, especially during piecemeal resection of large polyps. It is also helpful in reducing the size of a very large polyp before attempting snare resection, thus facilitating a safer and easier removal. Additionally, APC can be used to treat certain types of polyps such as those with villous architecture or those showing significant vascularity that might pose a high risk for bleeding during traditional snare polypectomy.

APC applications in polypectomy:

• Hemostasis control: To stop bleeding during or after polyp removal.
• Resection of small lesions: For smaller polyps that might be difficult to resect with a snare.
• Size reduction of large polyps: To make the polyp more manageable for snare resection.

Important Note: APC should be used cautiously, especially in close proximity to vital structures, and adequate training is critical to avoid potential complications such as perforation.

Example: A patient presents with a large pedunculated polyp, but the base is wide and vascular. Using APC to initially ablate some of the polyp’s tissue, reducing its size and bleeding risk, makes subsequent snare resection significantly safer and more effective.

Differentiating between benign and malignant polyps during endoscopy relies on several visual characteristics, although definitive diagnosis requires histopathological examination. Features suggestive of malignancy include:

• Size: Polyps larger than 1cm are more likely to be malignant.
• Shape: Sessile (flat) polyps have a higher risk of malignancy compared to pedunculated (stalked) polyps.
• Surface appearance: Irregular surface, ulceration, or friability (easily bleeds) are worrisome signs.
• Color: Polyps with areas of discoloration or dark pigmentation may be malignant.

However, it is crucial to remember that these are only suggestive findings. Many benign polyps might exhibit some of these features, and some malignant polyps can appear benign endoscopically. Therefore, complete resection and histopathological examination are crucial for definitive diagnosis.

Example: A 2cm sessile polyp with an irregular surface and areas of ulceration warrants careful examination and complete resection. While it might appear malignant endoscopically, the final diagnosis requires histopathological analysis after removal.

Histological features indicating malignancy in a polyp are assessed by a pathologist analyzing the resected tissue under a microscope. Key features include:

• Dysplasia: Abnormal cellular growth and architecture, classified as low-grade or high-grade. High-grade dysplasia is strongly suggestive of cancer.
• Invasion: Cancer cells extending beyond the mucosal layer into the submucosa or deeper tissues.
• Adenocarcinoma: The presence of cancerous glandular structures within the polyp.
• Lymphovascular invasion: Cancer cells invading blood or lymphatic vessels, indicating a higher risk of metastasis (spread to other parts of the body).
• Mucinous features: Abundant mucin production within the tumor cells.

The pathologist provides a detailed report that includes the type of polyp, presence and grade of dysplasia, presence of malignancy, and the depth of invasion, all crucial information for guiding further management.

Example: A report stating ‘tubular adenoma with high-grade dysplasia and invasion into the submucosa’ indicates a high risk of malignancy, necessitating close surveillance or further treatment, possibly surgical resection depending on the location and size.

The process of polyp retrieval and histopathological examination is vital for accurate diagnosis and treatment. After polypectomy, the removed polyp is carefully placed in a container with formalin, a fixative that preserves the tissue’s structure for microscopic examination. The container is labeled with the patient’s details, location of the polyp, and any other relevant information. The sample is then sent to a pathology lab where it is processed, embedded in paraffin wax, sectioned (sliced thinly), stained with hematoxylin and eosin (H&E) and other specialized stains if necessary, and then examined under a microscope by a pathologist.

Steps involved:

• Proper handling and fixation: Careful placement in formalin to prevent tissue degradation.
• Lab processing: Dehydration, embedding, sectioning.
• Staining: Applying H&E stain for visualization under the microscope.
• Microscopic examination: A pathologist analyzes the stained slides.
• Report generation: The pathologist generates a detailed report of findings.

Example: A carefully collected and properly preserved polyp from the colon allows the pathologist to accurately identify the type of polyp, the presence of dysplasia or malignancy, and the depth of any invasion, which is crucial information for informing the patient’s treatment plan. Proper handling is essential to ensure the quality of the sample and the accuracy of the diagnosis.

Management of patients with suspected adenomas during polypectomy involves a multi-faceted approach. The initial step is complete resection of the adenoma. The resected specimen will undergo histopathological examination, which will provide crucial information about the nature and severity of the adenoma (e.g. size, presence of dysplasia, and depth of invasion). Depending on these findings, further management decisions are made.

Management strategies for adenomas:

• Low-risk adenomas (small, no dysplasia): These often require only follow-up colonoscopies at intervals dictated by guidelines (usually 3-5 years) based on the patient’s risk factors.
• High-risk adenomas (large size, high-grade dysplasia, villous features): These may necessitate more frequent follow-up colonoscopies, potentially even within a year, and more aggressive surveillance strategies based on the findings. For example, if there are multiple high-risk adenomas found, further colonoscopy may be indicated sooner rather than later to ensure the colon has been thoroughly screened.
• Adenomas with invasive cancer: This requires immediate consultation with a surgeon or gastroenterologist to determine the best approach, which often involves surgical resection to ensure complete removal of the cancer and determine the next steps for further treatment.

Example: A patient with a large adenoma with high-grade dysplasia might require more frequent colonoscopies, possibly every six months or a year, to monitor for recurrence or any new polyps. If the pathology results reveal cancer, surgical intervention is necessary.

Polyp size and location are crucial in determining the need for polypectomy because they directly correlate with the risk of malignancy. Larger polyps (generally considered >1 cm) and those in difficult-to-reach locations have a higher chance of harboring cancerous or precancerous cells.

For example, a sessile polyp (flat and broad-based) of 1.5 cm in the right colon carries a higher risk than a small (<0.5 cm), pedunculated polyp (on a stalk) in the sigmoid colon. The location matters because polyps in the cecum or ascending colon may be harder to visualize and remove completely compared to those in the rectum. The size influences the technical complexity of removal, increasing the risk of complications. Guidelines often recommend polypectomy for most polyps exceeding 1cm, irrespective of their appearance. Smaller polyps might be observed if they are non-polypoid lesions.

Colonic polyps are classified into several types, based on their microscopic appearance and risk of cancer:

• Hyperplastic polyps: These are the most common and generally benign. They are small and often found in the right colon.
• Adenomatous polyps: These are precancerous and have the potential to develop into colorectal cancer. They are categorized by their shape (tubular, villous, tubulovillous) and size. Villous adenomas carry the highest risk of malignancy.
• Sessile serrated adenomas (SSA): These flat polyps are also considered precancerous, and their detection often necessitates surveillance or polypectomy.
• Inflammatory polyps: These develop as a result of chronic inflammation, often associated with inflammatory bowel disease (IBD). They are generally benign.
• Hamartomatous polyps: These are rare and include juvenile polyps and Peutz-Jeghers polyps. Some subtypes have a higher risk of malignancy.

Accurate identification of the polyp type is crucial as it dictates surveillance strategy post-polypectomy and the aggressiveness of follow-up.

Perforation during polypectomy is a serious complication. Management depends on the size and location of the perforation and the patient’s clinical status.

Minor perforations, often detected during the procedure, may be managed conservatively with close monitoring, intravenous fluids, and bowel rest. A potential approach might involve clipping the perforation site with a hemoclip.

Larger perforations often require surgical intervention, potentially including primary repair, resection, or even a temporary colostomy. The decision depends on several factors, including the patient’s hemodynamic status, the location of the perforation, and the surgeon’s judgment. The patient will require close monitoring in a hospital setting, and broad spectrum antibiotics are typically prescribed.

Early recognition and prompt management are key to improving outcomes and minimizing morbidity and mortality associated with perforation.

Imaging plays a crucial role in pre- and post-polypectomy assessment.

• Pre-polypectomy: Colonoscopy is the primary modality for identifying and localizing polyps. Occasionally, a CT colonography (virtual colonoscopy) might be used as a screening tool, though colonoscopy remains the gold standard for polyp detection and removal.
• Post-polypectomy: Following polypectomy, imaging is usually not necessary unless there’s a suspicion of incomplete resection or complications. If there’s concern, a follow-up colonoscopy might be performed to ensure complete polyp removal. Contrast-enhanced CT scans can sometimes be useful in assessing for perforation or other post-procedural complications.

For example, if a large polyp was removed and there’s evidence of bleeding, a CT scan might be used to assess for free air or localized bleeding. The choice of imaging modality depends on clinical suspicion and local protocols.

Adequate bowel preparation is essential for a successful polypectomy. A clean colon allows for optimal visualization of the colonic mucosa, enabling accurate identification and complete removal of polyps.

Typically, patients are given bowel preparation solutions (e.g., polyethylene glycol) to clear the bowel of stool and gas. The effectiveness of bowel preparation is assessed during the procedure. Inadequate bowel preparation can hinder visualization, leading to incomplete polyp removal or missed lesions which can affect the prognosis and increase the need for further procedures.

For instance, incomplete preparation could obscure a small polyp, leading to potential underdiagnosis and an increased risk of colorectal cancer. Therefore, proper bowel preparation instructions and patient compliance are crucial for optimizing polypectomy outcomes.

Proper patient positioning is critical for optimal visualization and access during polypectomy. The standard position is the left lateral decubitus position, allowing gravity to help clear the colon and facilitating access to different colonic segments.

Variations in positioning may be needed depending on the location of the polyp and the surgeon’s preference. For example, a polyp in the sigmoid colon may require adjustments to maximize visualization. Incorrect positioning can lead to limited access, increased procedure time, and potential incomplete resection or perforation. This is why the procedural team coordinates to achieve optimal positioning before beginning the procedure.

Sedation and analgesia during polypectomy aim to provide patient comfort and tolerance of the procedure while maintaining adequate hemodynamic stability and responsiveness.

The choice of sedation and analgesia depends on several factors including patient characteristics (age, medical history, etc.), polyp location, and the endoscopist’s preference. Commonly used medications might include propofol, midazolam, fentanyl, or other similar agents. A combination approach is frequently employed. Monitoring vital signs during the procedure is paramount to ensure patient safety. Patients may require additional post-procedure analgesia if discomfort persists. The exact dosage and approach are individualized based on the patient’s response and the endoscopist’s judgment.

I would always prioritize patient comfort and safety while ensuring they are adequately sedated to tolerate the procedure without compromising their airway and hemodynamic stability. Proper monitoring is crucial throughout the process to maintain safety and comfort.

My experience encompasses a wide range of endoscopic snares, each with its own strengths and weaknesses. The choice of snare depends heavily on the polyp’s size, location, and morphology.

• Standard Polypectomy Snares: These are workhorses, used for most polyps. They are simple to use and come in various diameters. I’m proficient in using both single-channel and dual-channel snares. The difference primarily lies in the ability to simultaneously inject saline or air during resection, which can improve visualization and reduce the risk of bleeding.
• Hot Snares: These employ electrocautery for cutting and hemostasis (stopping bleeding). I frequently use hot snares for larger polyps or those in more delicate locations, as they offer better control over bleeding. The temperature needs careful adjustment to prevent thermal injury to adjacent tissues. I always monitor the patient’s vital signs and use close observation during this type of polypectomy.
• Cold Snares: These are primarily used for the resection of delicate polyps where heat could cause damage. They rely on mechanical cutting, which is typically slower but gentler than hot snares. The advantage is less risk of perforation, particularly in areas like the cecum or transverse colon.
• Loop Snares: These are the most common type and are incredibly versatile, suitable for a majority of polyp sizes and locations. Their flexibility and ease of maneuverability make them ideal for reaching difficult areas.

For example, I recently used a hot snare for a large sessile polyp in a patient with a history of bleeding, ensuring precise control throughout the resection and minimizing the risk of recurrence. In another case, a cold snare was used for a delicate pedunculated polyp near the ileocecal valve to prevent injury to this sensitive area.

Patients with bleeding disorders present unique challenges during polypectomy. The goal is to minimize bleeding risk while effectively removing the polyp. My approach involves a multi-faceted strategy:

• Pre-procedural assessment: This is crucial. I thoroughly review the patient’s coagulation profile, including PT, PTT, INR, and platelet count. I also discuss the risks and benefits of the procedure, and in cases of significant bleeding risk, consult with hematology.
• Careful polyp selection: I prioritize removing only those polyps deemed necessary, considering the patient’s individual risk profile. Small, low-risk polyps might be left alone in some cases if the bleeding risk outweighs the benefit.
• Hemostatic techniques: I utilize techniques to minimize bleeding, including using bipolar electrocautery, argon plasma coagulation (APC), or injection of epinephrine. Cold snares may be preferred over hot snares to limit thermal injury. Water-jet lavage can help improve visualization and clear away blood.
• Careful monitoring: Constant monitoring of vital signs and bleeding during and after the procedure is crucial. I often have a strategy for managing potential post-polypectomy bleeding in place, possibly including blood products at the ready.
• Post-procedural care: Close monitoring of the patient in the recovery area following the procedure, paying close attention to signs of bleeding. Often I will provide instructions on dietary restrictions and activity limitations.

For example, a patient with von Willebrand disease undergoing a polypectomy would necessitate the use of meticulous techniques, and possibly pre-operative medication adjustments under hematology guidance. Post-procedure, close monitoring is essential for detection of any delay in coagulation.

Unexpected findings during polypectomy require a calm, methodical approach. My response depends on the nature of the finding.

• Adenocarcinoma: This is a serious finding. I would carefully mark the location and thoroughly document the appearance of the lesion. The procedure may need to be halted, possibly to obtain more extensive tissue samples. Referral to a surgeon is often necessary for planning resection.
• Sessile serrated adenoma or polyp: These require more complete removal due to higher malignant potential, and might require en bloc resection using techniques like EMR (endoscopic mucosal resection) or ESD (endoscopic submucosal dissection).
• Bleeding: If significant bleeding occurs, the procedure may need to be stopped to control the bleeding using hemostatic techniques as mentioned previously. In severe cases, a surgical intervention might be necessary.
• Perforation: This is a critical complication, requiring immediate cessation of the procedure, possible endoscopically assisted closure, and likely hospitalization. Surgical intervention might be necessary.

The key is careful assessment, documented findings and a prepared approach for managing potential complications. I always maintain open communication with the patient and their family, ensuring they understand the situation and the proposed management plan.

Advanced imaging techniques have significantly improved polypectomy. I have experience using:

• Chromoscopes: These enhance visualization of polyps by staining the mucosa differently. Indigo carmine, methylene blue, and Lugol’s solution are used, each with varying benefits in identifying dysplastic changes.
• Narrow-band imaging (NBI): This optical imaging technique improves the visualization of the microvascular structure of polyps, aiding in the detection of dysplasia and complete resection.
• Endoscopic ultrasound (EUS): EUS isn’t directly used *during* polypectomy but is critical in pre-operative evaluation for large or suspicious polyps, helping to assess depth of invasion in cases of suspected malignancy. This helps in determining the best approach for resection, either endoscopically or surgically.

Using these techniques helps me to identify and accurately remove polyps, improving the chances of complete resection and reducing the risk of recurrence. For instance, NBI can be invaluable in differentiating between benign and malignant polyps, informing the choice of snare and resection technique.

Improving patient outcomes after polypectomy involves a holistic approach:

• Complete polyp removal: Achieving complete resection reduces the risk of recurrence and future complications. Careful technique and using advanced imaging techniques are key here.
• Minimizing complications: Techniques like proper snare placement, injection of saline or epinephrine, and careful attention to hemostasis reduce the risk of bleeding and perforation.
• Patient education: Providing clear instructions regarding diet, activity, and potential complications enables patients to actively participate in their recovery.
• Follow-up care: Regular follow-up colonoscopies are crucial to monitor for recurrence and detect any new polyps. The interval of these depends on the size, number and histological type of polyps removed.
• Pain management: Addressing any post-procedural pain effectively improves patient comfort and contributes to a smoother recovery.

For example, clearly explaining the importance of following dietary restrictions after the procedure and providing contact information for any concerns minimizes post-operative problems and encourages a faster recovery.

Staying current in polypectomy involves continuous professional development:

• Participation in professional societies: I actively engage with organizations like the American Society for Gastrointestinal Endoscopy (ASGE), attending conferences, workshops, and webinars to learn about the latest advancements.
• Reading peer-reviewed journals: I regularly read leading journals in gastroenterology and endoscopy to remain updated on the latest research and best practices.
• Mentorship and collaboration: I collaborate with colleagues and mentors, sharing experiences and learning from each other’s expertise. This exchange of knowledge is invaluable.
• Continuing medical education (CME) courses: I actively participate in CME courses focused on advanced polypectomy techniques and management of complications.

For instance, a recent webinar on advanced endoscopic mucosal resection (EMR) techniques enhanced my skills in managing large and difficult polyps.