Klaus Mönkemüller shows the colon polyps that make polypectomy hard, case by case, in photos and video. He sorts them with the EndoCollab classification: by shape, size, number, location, histology, earlier biopsy, and syndrome.
Guests can watch the first 13 minutes. Members get all 66 minutes, with chapters and a searchable transcript.
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What you will learn
- The EndoCollab classification: shape, size, number, location, histology, iatrogenic, and syndromic polyps.
- Do not biopsy a polyp you think is resectable. Biopsies under-diagnose it and the fibrosis makes resection harder.
- Interventional chromoendoscopy: a blue submucosal cushion defines the borders and exposes flat archipelago-like lesions.
- Four-quadrant injection is a myth. One or two injections, even from in front of the polyp, can give a full cushion.
- Dynamic injection: the nurse pulses the syringe while you move the needle, the wheels, and the shaft.
- Snare pressure, strangulation, and water while cutting to disperse the current.
- Snare-tip circumferential incision, then the final snare: hybrid ESD-EMR for a lateral R0 margin.
- Thick stalks: endoloop or clips at the base, then cut at least 2 mm above the clips.
- The suction-mark trick so you never lose a small flat lesion again.
- The cecum, the anal verge, polyps between folds, inside a diverticulum, and a 5 cm lipoma.
- Lynch and Peutz-Jeghers: why a syndromic polyp is a complex polyp.
Inside the 66-minute lecture
38 chapters. The free preview runs to 13:14.
- 0:00Introduction and aimsFree preview
- 1:05The tiny polyp you see, then loseFree preview
- 1:58The EndoCollab classification for difficult colon polypsFree preview
- 2:57Do not biopsy a polyp you plan to resectFree preview
- 4:11Large polypsFree preview
- 4:54Bulky lesions: inject, then defineFree preview
- 6:03Laterally spreading lesions and chromoendoscopyFree preview
- 7:26The aim is R0 resectionFree preview
- 7:53The submucosal cushion and interventional chromoendoscopyFree preview
- 10:30Flat archipelago-like lesionsFree preview
- 11:36Snare orientation and the small defectFree preview
- 14:08Snare-tip incision for a lateral R0 marginMembers
- 16:17Four-quadrant injection is a mythMembers
- 18:40Injection solutions: mix it the color of the skyMembers
- 21:03Dynamic injection: the nurse and the endoscopistMembers
- 23:30Snare pressure and dynamic resectionMembers
- 24:52Snare-needle device and hybrid ESD-EMRMembers
- 28:48Laterally spreading tumors and piecemeal EMRMembers
- 30:51Depressed lesions and the pit patternMembers
- 32:33Non-granular flat lesions: when to markMembers
- 34:15Use water to tell left from rightMembers
- 34:45Lesions with a funny shape or baseMembers
- 36:17Proactive clip closureMembers
- 38:38Traction and countertractionMembers
- 39:39Thick stalks: endoloop and clipsMembers
- 44:50Small flat lesionsMembers
- 45:10The suction-mark trickMembers
- 46:32Multiple polypsMembers
- 47:12The cecum: injection and underwater EMRMembers
- 50:56Lesions found on retroflexionMembers
- 51:16Polyps hiding between foldsMembers
- 52:17On top of folds and at the anal vergeMembers
- 56:02Lipoma: enucleation with the snare tipMembers
- 57:23Diverticulum mimics and polyps inside a diverticulumMembers
- 59:24Iatrogenic polyps: after biopsy, and full-thickness resectionMembers
- 1:01:26Syndromic polyps: Lynch syndromeMembers
- 1:03:49Peutz-Jeghers syndromeMembers
- 1:05:11SummaryMembers
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