Complex Colon and Rectal Polyps

What happens if you have a colon or rectal polyp that could not be removed during your colonoscopy?

To the patient, the experience — and preparation — is similar to a colonoscopy and most patients are discharged the same day or within 24 hours.

As many as 10 to 15% of polyps found during a standard colonoscopy are unable to be safely removed during the same procedure, usually because the polyp is:

  • too large
  • located in a difficult area
  • very flat shape

These polyps — called complex polyps — will need additional procedures to remove them completely. Oftentimes, patients are referred to a surgeon. However, Roswell Park offers non-surgical options to treat complex polyps — without an operation and its associated risks, complications, and prolonged recovery time.

Non-surgical treatment for complex polyps

Most complex polyps can be treated with a non-surgical, endoscopic procedure. Rather than incisions on the belly, the physician uses an endoscope (long flexible tube with lighted camera) to access the colon through the anus in the same way your colonoscopy was performed.

During these procedures, our physicians use various techniques, such as injecting fluid under the polyp to lift it away from the colon wall, or forceps to pull it away, so that it can be removed safely and completely. These procedures include:

  • Endoscopic mucosal resection
  • Endoscopic submucosal dissection
  • Endoscopic full thickness resection

The procedure that is best for your polyp will depend on the polyp’s location, size and how deep the polyp has grown into the bowel wall.

Minimally invasive options for complex polyps

Most complex polyps can be removed completely and safely with endoscopic procedures. Some polyps, such as certain complex rectal polyps, very large polyps or polyps that have grown deeper into the bowel wall, may need a surgical procedure. However, these can still be performed using minimally invasive techniques, rather than a traditional operation. These include:

  • Robotic/Transanal minimally invasive surgery. These procedure for complex rectal polyps use robotic or laparoscopic surgical tools to perform endoscopic submucosal or full thickness excision. This procedure is also performed through the anus and may be an outpatient procedure, with a faster recovery.
  • Robotic or laparoscopic abdominal surgery. In these minimally invasive surgeries, the surgeon operates through small, keyhole incisions rather than a large traditional incision across the belly.

If surgery becomes necessary for your complex polyp, you’ll meet with Roswell Park’s colorectal surgeons to discuss which minimally invasive treatment is best for you.

Make an appointment

If your screening colonoscopy revealed a polyp that could not be removed during the procedure, you have other options. Come talk to us and learn how Roswell Park’s experts can help you.

Become a patient