Colonic polypectomy (with videos)

The role of colonoscopic polypectomy in the prevention of colorectal cancer is now well-established. Resection of adenomatous colonic polyps reduces colorectal cancer incidence(1) and mortality.(2) Despite this proven effectiveness, polyp resection techniques and outcomes remain understudied, and the potential for improvement in efficacy and safety is high. Advances in endoscopic and electrosurgical technology have allowed the role of endoscopic resection to expand, reducing the reliance on surgery for early cancer and larger or more complex lesions. The optimum resection technique for any given polyp is quick, ensures complete adenoma removal, and minimizes adverse events. Variations in polyp size, morphology, histology, and location mean that there cannot be a one-size-fits-all approach to resection technique and that polypectomy must be tailored to the characteristics of the lesion, based on the best available evidence. This review will focus on the technical aspects of endoscopic resection in the colon, highlight areas in which evidence is lacking, and comment on future directions in research.