LAUSR

Introduction Lumen filling giant pedunculated polyps can be challenging to resect and in some instances can be impossible leading patients to have surgery. Difficulties in polypectomy include an unstable position, large polyp head, unclear views and thick stalks. Here we describe an endoscopic technique which salvaged a challenging polypectomy. Methods A 62 year old lady attended after presenting with per rectal bleeding and passage of mucous. Initial colonoscopy showed a large pedunculated polyp with a pit pattern of type 4/5 which was thought to be malignant. CT scan was normal. On repeat colonoscopy there were no clear signs of malignancy. Results Despite numerous attempts it was impossible to capture the polyp with conventional snares even after applying volume reduction. Finally the polyp was resected by cutting the stalk using a SB Junior Knife (Scissors forceps). Three prophylactic clips were applied. Patient did not have any complications. Histology revealed a tubulovillous adenoma with low grade dysplasia. Conclusions This technique provides a useful option for performing polypectomy in challenging stalked polyps and should form part of every endoscopist’s armamentarium.