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Julio Alejandro Murra-Saca MD.
Gastroenterologist, Coloproctologist
Tel : (503) 226-3131, (503) 225-3087, Celular (503) 887-2507
:Email
 
Edificio Centro Scan, Colonia Médica, San Salvador, El Salvador.

 

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Notes on Cyber Gastroenterology

 

Polypectomy is a procedure to remove a colon or gastric polyp.

When a colonic or gastric polyp or polyps are detected by colonoscopy, polypectomy should be done to assure that an invasive malignant tumoris not present. because there is strong evidence of a premalignant potencial for colonic polyps.
A thin wire snare is passed through the scope and is is placed around the base of a polyp.

Using computer-controlled electrocautery current, the base of the polyp is first cauterized to prevent bleeding and then the stalk beneath is severed with the wire loop.

Please click on the image to download the video clip
A rectum polyp is being removed with wire snare polypectomy, You can see in the video clip the polyp fall away. The head of the polyp can now be retrieved and sent to the pathologist lab for a biopsy. Removing benign neoplasic polyps is prophylaxis against malignant degeneration.
For more endoscopic details please download the video clip by clicking on the image. Wait for download and if you wish appreciate in full screen press Alt and Enter.

Polypectomy can be defined as the endoscopic resection of polyps or tumors, obviating the need for open surgery. This is one of the most important scientific advances in the field of gastroenterology, since it enables us to treat many gastric or colonic tumors, without the inconvenience associated with major surgery. Our clinic has acquired a respectable experience in this procedure , having seen and treated many cases with this method, cases ranging from patients with small solitary polyps to multiple polyposis with numerous tumors. In one case , we resected 108 polyps from the same patient (in several sessions, over a period of four years), a feat which is considered a "World Record" by some of our colleagues.. The procedure or endoscopic polypectomy involves the introduction of a special wire through the endoscope which is connected to a surgical snare-cautery devise, enablelng the wire to cut and coagulate within the lumen of the bowel. Once the polyp is detected endoscopically, it can be resected with the use of this wire and any resultant bleeding can be controlled by this device{s possibility to coagulate. This procedure can be performed on an outpatient basis, eliminating the need for hospitalization. Normal everyday activity may be resumed almost instantly by the patient.


IMAGE OF ONE OF THE LARGEST POLYPS WE HAVE RESECTED IN ONE PIECE, WHICH MEASURES 6 X 2.8 CMS. MOST LARGE POLYPS ARE REMOVED IN SLICES OR IN SEVERAL SECTIONS.

The sequence below shows the step by step extraction of one of the largest polyps we have encountered. I can only remember one other polyps to be larger, which was extracted in several sections.

72 year old female who complained of hemorrhoids. She effectively did have hemorrhoids, but on digital rectal examination a large tumor was found before the first valve, which later proved to be a villous adenoma with dysplastic cells.

For more endoscopic details please download the video clip by clicking on the image, wait to be  downloaded complete and if you wish to appreciate in full screen press Alt and Enter.
Moment in which the tumor is being "roped" with the wire sling.

For more endoscopic details please download the video clip by clicking on the image, wait to be  downloaded complete and if you wish to appreciate in full screen press Alt and Enter.
Moment in which electric current is being applied to the wire.
For more endoscopic details please download the video clip by clicking on the image, wait to be  downloaded complete and if you wish to appreciate in full screen press Alt and Enter.
The tumor became dislodged leaving behind an ulcerative scar which will heal by itself.
For more endoscopic details please download the video clip by clicking on the image, wait to be  downloaded complete and if you wish to appreciate in full screen press Alt and Enter.
Post polypectomy ulceration after removal of a large pre-cancerous tumor.

Post-polypectomy ulceration with signs of healing, 8 days after procedure. The tissue granulates in a gradual fashion. Fibrin deposits become organized within two weeks.. The lesion will scar completely within time. One must emphasize the importance of detecting and treating these lesions while they are still curable. Only timely endoscopic diagnosis and treatment will allow us to beat these cancers. . Dont let cancer catch you by surprise. Undergo periodic complete medical -ups before symtoms have appeared. See Medical Check-Ups offered by our clinic.

 

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