ABSTRACT
Many local and systemic disorders can be diagnosed by rectal biopsy. The polyp can be retrieved easily by using suction or a polyp grasper or a biopsy forceps. The polyp site should be checked for bleeding or perforation. A small sessile polyp can be snared in the same way as a pedunculated polyp by including a small part of the underlying mucosa tented as a pseudopedicle. A circumferential villous or tubulovillous adenoma with the lower margin in the lower rectum can be removed even if the proximal margin extends to the midrectum. A large villous or sessile adenoma of the high rectum, with the lower margin more than 10 or 11 cm from the anal verge, is impossible to excise via a transanal approach unless the rectum can be prolapsed through the anus. Transanal endoscopic microsurgery is a relatively new operative technique to remove sessile lesions of the rectum, developed by G. Buess et al. of Germany.
