Atlas of Gastroenterological Endoscopy
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Multiple antral polyps
Multiple antral polyps Multiple antral polyps after adrenalin injection In this 70- year old patient with broad based polyps of the antrum a mucosectomy is indicated to eradicate the polyps. The right picture shows the polyp after adrenalin (1:20.000) injection of the base, the polyp gets lifted. An injection volume of 20 30 ml is required in this lesion, it helps to detach the submucosa from the muscular layer. If no lifting can be watched mucosectomy is discouraged for danger of perforation.
Mucosectomy Mucosectomy The polyp may be caught after lifting just by using a snare. Better results will be obtained if the lesion is first sucked into a ligation device. It is banded either by a rubber band (upper right picture) or by a snare introduced into a specially designed ligating tube (Olympus). Using an electric snare the polyp is excised (lower left picture). Using coagulation current the rate of hemorrhage is cut down, with pure cutting current the cutting is done more precisely. The pictures show a mucosectomy by means of a conventional rubber band ligation device. Main complications are hemorrhage and perforation.
Resulting resection
Results Results Results after 10 days
The first two pictures show the immediate results of mucosectomy done with coagulation current. The right picture shows the results after 10 days. The lesion has healed up considerably, hematin is looming through the superficial fibrin layer.