How colonoscopy finds and removes polyps, explained for Otisville patients

What polyp detection and removal looks like

During a colonoscopy we advance a thin, flexible colonoscope through the rectum into the colon. The scope has a high definition camera and a working channel for small instruments. When we see a polyp we choose the safest removal method based on size, shape and location.

• Small polyps, under about 5 millimeters. Often removed with biopsy forceps during the same exam.
• Polyps from about 5 to 20 millimeters. Usually removed with a snare polypectomy, which uses a wire loop to cut and cauterize the tissue.
• Larger or flat polyps. May need piecemeal removal or referral for advanced endoscopic techniques or surgery if size or location raises complexity.

Why removal during the same procedure matters

Removing polyps when they are found reduces the opportunity for abnormal cells to evolve into colorectal cancer. Sending the removed tissue to a pathology lab tells us whether cells are benign, precancerous, or require closer surveillance.

Guidance from professional groups such as the American College of Gastroenterology helps determine follow up intervals after polypectomy, and state resources explain screening recommendations for New York residents.

What you can expect during the visit

We perform colonoscopy under sedation. You will rest in recovery after the procedure until you are alert. Typical steps are:

1. Preparation. You follow a bowel preparation plan so the colon is clear for inspection.
2. The exam. We introduce the colonoscope and inspect the colon lining methodically.
3. Polyp removal if needed. We remove polyps using forceps or a snare and control bleeding with cautery or clips if necessary.
4. Specimen handling. We place removed tissue in a labeled container for pathology.

How pathology and follow up work

Pathology results usually arrive within several days to a couple of weeks. Results tell us the polyp type and whether there are high risk features that change surveillance timing.

We use the pathology report, plus the number, size and type of polyps found, to set the next colonoscopy interval. For details on general screening and surveillance intervals, the American College of Gastroenterology provides technical guidance, and New York State Department of Health describes local screening resources.

Signs that a polyp needed more than endoscopic removal

Most polyps are removed endoscopically. We consider referral for advanced endoscopic resection or surgery when a polyp is very large, involves difficult anatomy, or cannot be safely removed in one piece. In those cases we explain the options and coordinate care.

Key concepts to know before your colonoscopy

• Detection. High quality visualization depends on a clean colon and careful inspection.
• Removal. Immediate polypectomy is standard when safe to do so.
• Pathology. Tissue analysis guides surveillance.
• Surveillance. The timing of the next exam depends on polyp findings and guidelines.

How we approach this at our practice

We are Dr. Alan R. Plumer, MD, a gastroenterologist serving Goshen and nearby communities including Otisville. We perform colonoscopies as part of colorectal cancer screening and diagnostic care, and we work with pathology and surgical colleagues when advanced care is needed. Learn more about our colonoscopy service and related care through our colonoscopy page and our gastroenterologist page.