The Polypectomy Masterclass: Right Technique, Right Lesion, First Time
The highest-volume therapeutic act in endoscopy, where small differences in technique compound into large differences in recurrence and cost. Everyday polypectomy up to standard complexity — the advanced service belongs to Friday.
Running order (indicative)
- Head
- Dr John Andersonanchors the studio throughout
- Talk 1
- Dr Andrea SorgeCold Against Hot: Where the Boundary Really Sits in 2026
- Talk 2
- Dr Philippe LeclercqClip Closure: Evidence, Habit, or Insurance Policy?
- Talk 3
- Dr John AndersonDon't Stop the Anticoagulant: An Evidence Review
- Live case
- Dr Lobke DesomerDr Mariana Figueiredo FerreiraLarger polyp for cold-snare polypectomy
- Live case
- Dr Barbara BastiaansenDr Manmeet MatharooLaterally spreading tumour (LST) for complex lesion assessment & SMSA scoring
- Discussion
- Allremaining session time
The session, as written
Lecture 1 — Cold against hot: where the boundary really sits in 2026. (Sorge — first author of the meta-analysis). Adenomas against serrated lesions, and the value trade that makes cold snare the default — until it isn't. Cold snare needs no clip, no cautery kit, and less of everything: the green default as well as the safe one.
Lecture 2 — Clip closure: evidence, habit, or insurance policy? (Leclercq). When a clip is cheaper than repeating the procedure — and when seven clips on seven polyps is money down the scope channel and single-use metal in the bin. Need against habit, costed by number-needed-to-treat; and where multiple clips are genuinely indicated, one deployment device shared across the case beats opening a fresh one per clip.
Lecture 3 — Don't stop the anticoagulant: an evidence review. (Anderson). The guidelines restart anticoagulation at day three, then blame the polypectomy. The stroke-versus-bleed value equation, cold snaring on anticoagulants, and what the data actually supports — a review built for this meeting.
Live case 1 — cold snare, narrated. Snare choice, position, resection — the ten-second habits that determine completeness.
Live case 2 — the lesion you should not remove today. A laterally spreading lesion assessed and SMSA-scored live — and the highest-value act turns out to be restraint: recognising the lesion that goes to the Friday service, not today's snare. The bridge to Day 2, built in the room.
