GI Endoscopy · 2 min read
Polypectomy: Which Snare for Which Polyp?
COURSE VIDEO
Course: Basics in Endoscopy
00:00 – Course Objectives & Overview of Snare-Based Polypectomy
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00:00 – Course Objectives & Overview of Snare-Based Polypectomy
00:40 – Snare Taxonomy: Wire Type, Shape & Catheter Gauge
02:12 – Five Pillars of Safe Resection (Snare Choice, Current, Positioning, Cushion, Dynamics)
04:12 – Historical Milestones: From Shinya & Ishikawa to Modern Practice
06:07 – Incomplete Resection Data & Electrosurgical Current Selection
11:10 – “Interviewing” the Polyp: PARIS, Kudo, NICE, SANO & JNET
15:03 – Advanced Snare Engineering: Rotatable, Multi-diameter & Needle-Snare Combos
18:18 – Cold-Snare Technique for Small Polyps (Step-by-Step)
26:12 – Dynamic Submucosal Cushion & Interventional Chromoendoscopy
34:37 – The “Y-Pressure” and Tenting Maneuvers
37:54 – Managing Pedunculated Lesions & Vascular Stalks
42:00 – Hybrid EMR/ESD for Large Lateral-Spreading Tumors
48:09 – Piecemeal EMR Pearls & Margin Ablation
50:15 – Key Take-Home Messages & Procedural Checklist
About the Course
Objective
Provide a comprehensive, practice-oriented mastery of snare selection and technique so that endoscopists can achieve consistent R0 resections across polyp morphologies and sizes.
Key Highlights
Side-by-side comparison of braided vs. monofilament, hexagonal vs. oval, and single- vs. multi-diameter snares.
Evidence-based guidance on current settings to balance hemostasis, margin readability, and transmural safety.
Live demonstrations of cold, hot, and hybrid EMR/ESD resections with real-time commentary on scope torque, wheel control, and assistant coordination.
Course Content Overview
Introduction to Snare-Based Polypectomy – Why snare design matters and how procedural dynamics influence outcomes.
Snare Classification & Anatomy – Material properties, catheter gauges, and how each parameter affects cutting efficiency and retrieval.
Electrosurgical Fundamentals – Choosing cut, coagulation, or blended currents based on lesion context and submucosal lift.
Lesion Assessment Framework – Applying PARIS, NICE, and JNET in real time to predict histology and select an optimal resection plan.
Cold-Snare Mastery for Small & Flat Lesions – Stepwise technique, polyp sizing hacks, and the “See-Suction-Resect” paradigm.
Dynamic Submucosal Cushion Technique – Creating a blue-stained lift for safety, margin visualization, and reduced thermal injury.
Advanced Maneuvers: Y-Pressure & Tenting – Ensuring complete capture, preventing deep burn, and troubleshooting poor positioning.
Pedunculated & Vascular Stalk Management – Prophylactic injection, clipping strategies, and monofilament rescue snares.
Hybrid Approaches for Large Lesions – Snare-tip pre-cut, circumferential incision, and vertical-lateral R0 strategy.
Piecemeal EMR Optimization – Combining large and small snares, air deflation, and margin ablation to curb recurrence.
Procedural Checklist & Future Modules – Scope/channel readiness, electrosurgery cheat-sheet, and upcoming content on dynamic scope movements.
By the end of this course, you will confidently select and deploy the appropriate snare for any colorectal lesion, execute advanced cushion and tenting techniques, and systematically minimize recurrence through evidence-based electrosurgery and margin control.
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