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Patient Profile
Patient Name
Mr. Anand Deshmukh
Age / Gender
58 Years / Male
Consultant
Dr. Vipulroy Dayanand Rathod
Hospital
Fortis Hospitals Limited, Mulund, Mumbai
Diagnosis
Early Oesophageal High-Grade Dysplasia in Barrett’s Oesophagus
Past History
Mild iron deficiency anemia on routine blood work, family history of colorectal cancer in a first degree relative, no prior colonoscopy
Patient Background
Mr. Anand Deshmukh, a 58-year-old retired bank officer from Pune, Maharashtra, was advised a screening colonoscopy after routine blood work showed mild iron deficiency anaemia. He had no bowel symptoms at the time and felt generally well, but his family history of colorectal cancer in a first degree relative made early screening a priority for his physician. During the colonoscopy, a large flat growth was found in the ascending colon. Given the size and shape of the growth, his family sought a specialist experienced in advanced polyp removal. Dr. Vipulroy Rathod, Consultant Gastroenterologist at Fortis Hospitals Limited, Mulund, Mumbai, and an expert in therapeutic colonoscopy, recommended Endoscopic Mucosal Resection (EMR), a minimally invasive technique that removes such growths entirely through the colonoscope, avoiding the need for bowel surgery.
Symptoms
Largely asymptomatic presentation, the polyp was detected incidentally during screening colonoscopy
Mild fatigue attributed to iron deficiency anaemia found on routine blood tests
Occasional vague lower abdominal discomfort, not clearly linked to bowel habit
No overt rectal bleeding or visible blood in stool
No unexplained weight loss or change in bowel habit
Diagnostic Method
Screening colonoscopy
identified a large flat, sessile growth measuring approximately 3.5 centimetres in the ascending colon, with no evidence of ulceration or spontaneous bleeding
High definition white light and narrow band imaging
characterised the surface and pit pattern of the growth, features favouring a benign adenomatous polyp suitable for endoscopic removal rather than surgery
Chromoendoscopy with dye spray
outlined the margins of the polyp clearly, confirming it was confined to the inner lining and had not invaded the deeper bowel wall
Biopsy and histopathology
confirmed a tubulovillous adenoma with low grade dysplasia and no features suggesting invasive cancer
Pre-procedure evaluation
included blood investigations, correction of anaemia, and fitness assessment for advanced therapeutic endoscopy
Disease Diagnosed
Mr. Deshmukh was diagnosed with a large tubulovillous adenoma of the ascending colon, a benign but pre cancerous growth that, if left in place, carries a meaningful risk of progressing to colorectal cancer over time. Because of its flat, sessile shape and size, the polyp could not be safely removed with a simple snare alone. As a specialist in advanced colonoscopic techniques, Dr. Rathod identified Endoscopic Mucosal Resection as the most appropriate method to remove the growth completely while preserving the healthy bowel wall and avoiding open or laparoscopic surgery.
Risks if Left Untreated
Gradual progression of the adenoma toward colorectal cancer
Continued occult blood loss and worsening of iron deficiency anaemia
Growth of the polyp to a size or depth that would eventually require surgical bowel resection
Risk of bleeding or obstruction if the polyp were to enlarge further
Treatment Plan
Dr. Vipulroy Rathod performed Endoscopic Mucosal Resection, a therapeutic colonoscopy procedure that lifts and removes abnormal tissue from the inner lining of the colon using a colonoscope, without any cut on the abdomen.
Why EMR Was Chosen Over Surgery
01 — No Abdominal Incision
The entire resection is carried out through the colonoscope. No abdominal cuts, no external scars, and no surgical wound to heal.
02 — Bowel Preserving
Unlike a surgical colon resection, EMR removes only the abnormal lining and spares the healthy bowel, so there is no need to rejoin or shorten the colon.
03 — Piecemeal or En Bloc Technique
The resection technique can be tailored to the size and shape of the polyp, improving the chance of complete removal in a single session.
04 — Faster Recovery
Hours of observation instead of a week or more of surgical recovery. Most patients resume a normal diet within a day, compared to a longer recovery after bowel resection surgery.
How the Procedure Was Performed
- Submucosal lift: a fluid cushion was injected beneath the polyp to lift it away from the deeper muscle layer, creating a safe plane for resection
- Snare resection: the lifted polyp was captured with a wire snare and removed using controlled electrocautery, taken in segments given its size
- Margin inspection: the resection site was examined closely with narrow band imaging to confirm no residual abnormal tissue remained at the edges
- Thermal ablation of margins: the rim of the resection site was treated to reduce the chance of any leftover cells regrowing
- Site closure: endoscopic clips were placed across the resection bed to close the defect and reduce the risk of delayed bleeding or perforation
Procedure Summary
Procedure | Endoscopic Mucosal Resection (EMR) of a large colonic polyp |
Approach | Entirely transanal through the colonoscope, no external incision |
Duration | 55 minutes |
Sedation | Conscious sedation with continuous monitoring |
Hospital Stay | Same day discharge after a period of observation |
Doctor’s Quote
“A polyp of this size in the ascending colon would once have meant surgery for most patients. With Endoscopic Mucosal Resection, we lift and remove the growth from within the colon itself, leaving the bowel wall intact and avoiding any abdominal incision. Mr. Deshmukh went home the same day and was back to his normal routine within a couple of days. For a growth like this, EMR gives patients a complete answer without the recovery of an operation.”
Dr. Vipulroy Rathod, Consultant Gastroenterologist, Fortis Hospital, Mulund, Mumbai
Post-Procedure Guidelines
Clear liquids for a few hours after the procedure, advancing to a light and then normal diet over the next day
Avoid heavy lifting and strenuous activity for about a week to lower the risk of delayed bleeding
Watch for and promptly report abdominal pain, fever, or blood in the stool
Continue iron supplementation until anaemia fully resolves
Follow up colonoscopy at the interval advised by Dr. Rathod to confirm complete healing of the resection site
Outcome
Same Day | Uneventful recovery from sedation, no immediate bleeding, discharged with routine advice |
1 Week | No abdominal pain or bleeding, back to normal daily activities |
1 Month | Anaemia showing steady improvement, feeling well overall |
3 Months | Follow up colonoscopy confirmed a well healed resection site with no residual polyp |
6 Months | Blood counts normalised, patient continues a routine screening schedule |
Long-Term Expectations
With the polyp completely removed and the resection site healed, Mr. Deshmukh’s risk from this particular growth has been addressed at an early, pre-cancerous stage. Since new polyps can form elsewhere in the colon over time, periodic surveillance colonoscopy will remain part of his ongoing care, along with continued monitoring of his blood counts. Prompt evaluation of any new bowel symptoms will also remain an important part of his long term follow up.
Patient Feedback
Dr. Rathod explained everything clearly and removed it through the scope itself, with no operation needed. I was home the same evening and back to my usual routine within a couple of days. I am grateful this was caught and treated so early.”
Anand Deshmukh, 58 | Pune, Maharashtra
“We were anxious when the doctors said the growth was quite large. Dr. Rathod and his team reassured us that it could be handled through the scope, and that is exactly what happened. My husband was up and about within days, and the follow up results have been reassuring. We are thankful for the care he received.”
Mrs. Sunita Deshmukh, Patient’s Wife | Pune, Maharashtra
