Piecemeal polypectomyResection of a polyp along a fold. (a) Maximum air insufflation of the lumen shows that the polyp is on a fold. (b) The tip of the opened snare is placed behind the polyp. The snare is then pushed and firmly pressed against the bowel wall to spread out the fold exposing the entire loop. (c) Using the tip of the snare as a fulcrum the snare is pivoted to the left by bending the tip of the endoscope. The left part of the polyp is engaged into the snare. (d) The ensnared polyp portion is lifted into the bowel lumen and resected under optimal endoscopic control. Complete polypectomy is accomplished with piecemeal technique from the left to the right.
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