Lesion: Large sessile lesion in the proximal ascending colon; surface pit pattern and vascular pattern - benign look.
Injection: 3 cc of 1:10,000 epinephrine into the head of the polyp followed by 4 cc into the base to lift the polyp from the muscularis propria.
Snare resection: 25 mm snare; Endocut 3-1-6 settings; slow cut.
Resection base: blue indicative of submucosal plane of resection; vessels noted with slight ooze; treated with hemostatic forceps soft coagulation at 80 W.
Resection edge: APC to prevent recurrence
Clip closure to prevent delayed bleeding.
Pathology: Tubulovillous adenoma; multifocal high grade dysplasia; edge and base clear of adenoma. |