Colonoscopic Polypectomy

WHAT YOU SHOULD KNOW:

• Colonoscopic polypectomy is surgery to remove colorectal polyps. Colorectal polyps are small lumps of tissue in the lining of the colon and rectum. Some polyps, such as hyperplastic polyps, are usually benign (noncancerous) and may not cause any symptoms. Other polyps, such as adenomatous polyps, may develop into cancer (tumor). The colon and rectum are also called the large bowel. They are part of the digestive system in the lower part of the abdomen (stomach). The digestive system is where food is swallowed and broken down. The colon is the first section of the large bowel where stool (bowel movements) form. The rectum is the last part of the large bowel where stool stays before leaving the body.
  
  
• In a colonoscopic polypectomy, your caregiver uses a colonoscope, which is a soft, bendable tube with a light and tiny camera on the end. Special tools may be passed through a channel (tunnel) in the colonoscope to remove polyps. How colorectal polyps will be removed depends on the type, shape, size, and location of the polyps. They may be removed by snaring (lassoing them) with a wire loop that cuts and burns them off. If they are small, they may just be burned off. Polyps may be removed one tiny piece at a time if they are large, or in one piece if they are small. With colonoscopic polypectomy, colorectal polyps may be removed, your symptoms relieved, and colorectal cancer may be prevented.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• A colonoscopic polypectomy carries certain risks. You may have a slow heartbeat, decreased blood pressure, increased sweating, or faint (pass out). You may have pain or bleeding as the scope is passed inside your colon and after your surgery. You may have bleeding or a burn on the wall of your colon from the removal of your polyps. Your colon may be perforated (torn) due to the increased pressure from the scope or from the instruments used. This may cause bowel contents to leak out of the colon and into your abdomen. If this happens, you will need to stay in the hospital and have surgery on your colon. Following your caregiver's advice during and after the surgery may decrease your chances of having any problems.
  
  
• Without this surgery, your signs and symptoms may continue and worsen. Colorectal polyps may not be removed and may develop into cancer, which may cause problems that are more serious. Ask your caregiver if you are worried or have questions about your surgery, medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

During your surgery:

• You are taken on a stretcher to the colonoscopy room and then moved onto a special bed or table. You are given medicine to help you relax, especially if you feel anxious or nervous. You are positioned on your left side and one or both knees are raised toward your chest. Your caregiver will examine your anus (rear end) and use a finger to perform a digital rectal exam to check your rectum. He will also feel for your prostate if you are a male. If your bowel is not totally empty, your caregiver may give you another enema.
  
  
• During your surgery, the colonoscope is lubricated with jelly and gently placed into your anus. It is then passed through the rectum and into the colon. Water or air is put into the colon to help clean or distend (expand) it. Distending the colon helps the colonoscope to pass through easier and your caregiver to better see your colon. Take small, deep breaths through your mouth and tell your caregiver if you feel too uncomfortable. Your caregiver may inject fluid under the polyp or use dye to mark it to make it easier to remove. He will pass a snare (wire loop) through the colonoscope and use it to lasso the polyp. The polyp is then burned or cut off the wall of the colon. Small, special tools may also be used to burn or cut the polyp off the wall of the colon. Polyps are removed in one piece or one tiny piece at a time, if they are large. The polyps that are removed are sent to a lab for tests. Your caregiver may videotape or take pictures of the inside of your colon while doing the surgery. When the surgery is finished, the scope is slowly removed and your anus is wiped with gauze.

After your surgery:

You may lie in bed and rest for a while since the surgery may be a little tiring. You may pass some air that may be left in your colon. You may see blood in your bowel movement (BM) from the removal of your polyps. When your caregiver sees that you are OK, you will be allowed to change clothes and go home. You will need someone to drive you home if you were given medicine to relax you. Do not drive home alone. If your caregiver wants you to stay in the hospital, you will be taken back to your hospital room.

• Monitoring: Caregivers will check your temperature and other vital signs to make sure that you are OK. Caregivers may also check for your pulses on your arms or wrists. This helps caregivers learn if you have problems with blood flow after your procedure. Caregivers will check your blood sugar after surgery. This may help decrease your chance of getting an infection.
  
  
• Drinking liquids: Men 19 years old and older should drink about three Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about two Liters of liquid each day (about 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, healthy liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Medicines: You may need any of the following:
  
  
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Blood thinners: This medicine helps prevent clots from forming in the blood. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
    
    
  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
  
  
• Preventing blood clots: Around the time of your surgery or procedure you may need to take medicine to thin your blood. Blood thinning medicine helps prevent blood clots from forming in your veins. This medicine makes it easier for a person to bruise and bleed. You will need regular blood tests while taking this medicine. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you use. Physical activity helps prevent blood clots. Caregivers will help you be as active as possible after your surgery or procedure.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.