How are colorectal polyps removed?

Written by: Mr Matthew Tutton
Published: | Updated: 03/08/2021
Edited by: Robert Smith

A colorectal polyp is a small growth that can be found on the lining of the colon or rectum. Sometimes they can grow larger and can be malignant. Therefore it’s often important to have them removed with surgery.

colorectal polyps


We spoke with Mr Matthew Tutton who is a leading consultant general and colorectal surgeon, who let us know how colorectal polyps can be treated and when a colonoscopy or transanal endoscopic microsurgery (TEM) should be carried out.

What exactly are colorectal polyps?

Polyps are abnormal growths of the inner lining of the bowel. Some can be flat, whereas others appear like little mushrooms within the bowel. Polyps in the bowel will occur in about 20 per cent of the UK population. By far the majority of these polyps are innocent and benign. The majority of these can be removed by cutting them away during a colonoscopy when a flexible tube is passed via the back passage into the bowel; sometimes, this is done under sedation. A proportion of polyps grow in the last part of the bowel, the rectum, near the back passage. Some polyps can grow to be very large and some may contain cancerous cells, they can often take many years to develop. Conventionally these larger polyps have often been treated with more major surgery.

What are the symptoms of colorectal polyps?

Colorectal polyps may make the bowel habit irregular, some cause bleeding and others may lead to the passage of mucus from the back passage. Occasionally polyps near the back passage can cause pain and discomfort. Some of these polyps will be detected by the National Bowel Screening Program when a stool sample is tested for the presence of blood. If a stool sample is positive, then you will be invited to attend for a colonoscopy. If someone has a strong family history of bowel cancer or polyps, then regular colonoscopies may be recommended following an assessment of your risk.

What treatment options are there for polyps?

A large number of colorectal polyps can be removed at the time of the colonoscopy. Special techniques use fluid to raise the polyp away from the bowel wall and then metal snares with an electric current can remove the polyp. If the polyp is too large or is an early cancer, it may not be removed by colonoscopy. For polyps within the rectum, a large number can be treated with a minimally-invasive operation called transanal endoscopic microsurgery (TEM). This is an operation performed under a general anaesthetic. Whilst asleep, a special tube is placed into the back passage and under the guidance of a high definition (HD) microscope, surgical instruments can be placed through the tube into the rectum to remove the polyp. With this technique, a special waterjet elevates the polyp away from the rest of the rectal wall and the HD microscope allows precise excision of polyps and tumours without damage to surrounding tissues and the deeper structures of the bowel wall.

How long does it take to recover from transanal endoscopic microsurgery?

There is a fairly quick recovery time. For most patients with polyps removed at colonoscopy, there are very few symptoms. There can occasionally be some discomfort or bleeding. Techniques such as the TEM operation can often be performed as a day-case procedure. There is very little pain from the procedure and risks are small. The tissues in the rectum regenerate over the next few weeks and the bowel habit usually returns to normal during this healing period.

Would a follow-up appointment be needed?

A large number of polyps will need no further follow-up. Depending on the size and nature of some polyps, patients may require further colonoscopy at set times frames to ensure no further or recurrent polyps form.

If you require treatment for colorectal polyps, you might like to book an appointment with a leading consultant general and colorectal surgeon such as Mr Matthew Tutton. Visit his Top Doctors profile today for more information.

By Mr Matthew Tutton

Mr Matthew Tutton is a leading consultant general and colorectal surgeon who currently sees patients at the Oaks Hospital in Colchester. Mr Tutton’s clinical interests include laparoscopic and minimally invasive surgery. He’s a specialist in colorectal surgery. His practice includes laparoscopic and open surgery for all types of hernia repairs, bowel resections, gallstones as well as THD for haemorrhoids and VAAFT for fistulas. He is an expert in colonoscopy and gastroscopy and performs TEM local excision for large rectal polyps and early cancers.

Mr Tutton’s medical training was at Guy’s and St Thomas’ Hospitals. He also has a Bachelor of Science Degree in neurosciences. Research for his thesis in colorectal cancer and Master of Surgery Degree was based at the Royal Marsden Hospitals and the Institute of Cancer Research.

Mr Tutton has presented both international and national papers related to colorectal surgery. He has also published book chapters, papers and presented internationally on topics including laparoscopic hernia repair and laparoscopic gallstone surgery.

He has given many lectures including to the European Association of Endoscopic Surgeons in Stockholm and Athens as well as performing live surgery demonstrations to international meetings. As a consultant surgeon, Mr Tutton has undertaken travelling fellowships to Japan and the USA to develop minimally invasive surgical techniques. Mr Tutton has held honorary senior lecturer posts at the Anglian Ruskin University, University of Cambridge and Queen Mary, University of London and is currently the Divisional Director for Surgery, Gastroenterology and Anaesthetics at ESNEFT.

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