Polypectomy at Hereford Hospital

What conditions does polypectomy treat? 

Polyps can form in several organs. A polypectomy may be used to remove polyps from: 

• The colon (large bowel) 
• The uterus (womb) 
• The stomach 
• The gallbladder.

Most polyps are non-cancerous (benign), but some are precancerous, which means they could develop into cancer over time if left in place. Removing them reduces the risk of bowel cancer, stomach cancer, and other cancers depending on the location. 

A polypectomy may also be recommended when polyps are causing problems such as uncontrolled bleeding, pain, blockages, or difficulties with menstruation or fertility. 

What are the benefits? 

Removing polyps early means they can be dealt with before they cause harm or become cancerous. Many clinicians recommend removing all polyps as a precaution, even ones that appear harmless at the time, as polyps can continue to change. 

Because polypectomy is minimally invasive, most people go home the same day. In many cases, a polyp found during a routine examination of the bowel or womb is removed at the same appointment. 

Types of polypectomy 

The approach depends on where your polyp is and how straightforward it is to remove. 

• Endoscopic polypectomy: This is the most common type. It uses an endoscope, a long, flexible tube with a camera at the end, which is passed through a natural opening in your body. For bowel polyps, this is done through the anus during a colonoscopy (an examination of the large bowel). For womb polyps, a hysteroscope (a similar instrument designed for the uterus) is passed through the cervix. 
• Hysteroscopic polypectomy: This is used specifically for polyps inside the uterus. A small amount of liquid is introduced into the womb to open it up so the surgeon can see the inside clearly and remove the polyp. 
• Laparoscopic (keyhole) surgery: This is used when a polyp cannot be reached through an endoscope. This involves a few small cuts, each around half an inch in size, through which a camera and surgical instruments are inserted. 

Before your procedure 

What you need to do before your procedure depends on the type of polypectomy:

• For a bowel polypectomy your bowels need to be completely clear beforehand. Your clinical team will give you a bowel preparation formula to use in the days leading up to the procedure. This involves following a special diet and can take up to 24 hours to complete. 
• For a hysteroscopic polypectomy (to remove a womb polyp), you will attend a pre-operative clinic about a week before the procedure. Your weight and blood pressure will be checked, and any further tests will be arranged if needed. 

If your procedure requires a general anaesthetic (medicine that puts you fully to sleep), you must not eat or drink for at least 6 hours beforehand: 

• If your admission time is 8:00am, fast from midnight 
• If your admission time is 12:00 noon, fast from 8:00am; a light breakfast before this time is advised 

For a hysteroscopic polypectomy, also: 

• Arrange transport home by car or taxi; public transport is not suitable on the day 
• Ask a responsible adult to stay with you for 24 hours after the procedure 
• Remove makeup, nail varnish, and jewellery before coming in 
• Bring a list of all your medications, including inhalers or herbal remedies 
• Tell the nursing team if you have a cold, sore throat, or think you may be pregnant 
• Your team will advise on which medications you should continue or stop before the procedure. 

What happens during the procedure? 

Most polypectomies are carried out while you are awake. You will be given a sedative (medicine to relax you) and pain-blocking medication through a drip into your vein. You may feel a vague sense of pressure or pulling during the procedure, but you should not feel pain. If you prefer to be fully asleep, general anaesthetic is available. 

For an endoscopic polypectomy, your surgeon will: 

1. Pass the endoscope through the appropriate natural opening (the mouth, anus, or cervix) 
2. Use the camera to project images onto a screen and locate the polyp
3. Pump carbon dioxide gas through the endoscope to gently inflate the organ for a clearer view 
4. Insert small instruments through the scope: forceps (a gripping tool) or a wire snare (a small loop used to cut around the base of the polyp) 
5. Seal the area with an electrocautery device, a tool that uses a small electrical current to burn away any remaining tissue and close the wound 

A hysteroscopic procedure to remove a womb polyp follows a similar process and usually takes 10 to 15 minutes. Under general anaesthetic, it takes around 15 to 30 minutes. 

Recovery from polypectomy 

Most people who have a polypectomy under sedation are able to go home the same day. If you have a hysteroscopic polypectomy, you will usually be expected to stay on the ward for most of the day. 

You will be given mild pain relief while on the ward if needed, and instructions about what to take at home. 

For the first 24 hours after a hysteroscopic polypectomy, avoid: 

• Driving or operating any machinery  
• Drinking alcohol 
• Signing any legal documents. 

At home after a hysteroscopic polypectomy: 

• Rest for 1 to 2 days 
• Most people can return to work within 1 to 2 weeks 
• You may experience some light bleeding or discharge for 7 to 10 days; use pads rather than tampons during this time 
• Avoid intercourse for 1 week, or until any bleeding has settled.

Risks and complications