Patient: Elderly overweight woman with a large transverse colon polyp was referred for endoscopic resection as an option to try before surgery.
Preparation: Split dose preparation
General anesthesia with endotracheal intubation as the transverse colon moves too much with respiration.
Adult colonoscope with a cap.
Injection: Indigo Carmine with 13 ml (two injections)
Snare resection: 15 mm stiff snare; right sided backhand flip technique for the first resection. Two resections done with a 15 mm snare; small edge cleanup with a 10 mm snare.
Base: Blue base with no bleeding or residue.
Edge: Looks clean; as per the protocol, treat with APC
Clip closure: Two Cook Clips and and remaining with Resolution Clips.
Post-procedure: Liquid diet for 2 days; low residue diet for 2 days; regular diet on day 5.

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