Global Online Endoscopy Trainer - Scores - Global Polypectomy Assessment Tool

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Type - Hot/Cold
Global
Injection Technique
Snare Placement Technique
Safety Checks prior to Resection
Defect Assessment
Accessory Techniques
Difficulty Scores

Scores

Overall: /

Fraction:

SMSA:

SMSA Group :

SMSA+: /

Weighted Fraction:

Pre-requisites:

Colon Polyp ≥ 10mm in size

Cold or Hot Snare

This tool asks for your subjective assessment of multiple domains of deconstructed polypectomy where 1 is poor and 5 very good

Fill hot or cold first since different questions are asked for each.
The difficulty score consists of SMSA questions (4).
The difficulty+ score consists of SMSA+ questions (4) and applies only to hot snare.

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Demographic Details

Date of Procedure

Hot / Cold Snare Polypectomy?

Type of Polypectomy

Global Competencies

Score: /

Tip control:

Fully appreciates / demonstrates extent of the polyp to be resected:

Positioning with respect to the polyp:

Technique selected is appropriate for the polyp resected?

Injection Technique

Score: /

Injection is performed in the correct plane:

Injection is performed dynamically:

Injection is used to improve lesion access:

Snare Placement Technique

Score: /

Appropriate Snare Size Selected:

Stable positon with lesion at 6 'o clock OR transformed to 6 'o clock:

Maximises Tissue Capture:

Snare precisely visualised during placement and closure (V of the snare):

Residual tissue islands avoided if piecemeal resection OR Macroscopically complete if en-bloc resection attempted:

Safety Checks Prior to Resection (HOT snare only)

Score: /

Moves the closed snare to confirm independent movement from deeper structures:

Lifts the snare away from the muscularis propria prior to application of diathermy:

Defect Assessment After Resection

Score: /

MUCOSA - Looks for, detects and removes residual at margin and within defect:

Thermal ablation of the POST EMR Margin:

SUBMUCOSA - Looks for, detects and treats any bleeding vessels within the defect::

MUSCULARIS - Looks for, detects and treats Deep Mural Injury ≥ 2 (Sydney Classification) :

Accessory Techniques in Polypectomy

Score: /

Placement of Through the Scope CLIPS:

Use of Polyp Retrieval Device:

Use of Coagulation grasper

Difficulty Score (SMSA - EMR, SMSA+)

SMSA

Size:

Morphology:

Site:

Access:

SMSA +

Size ≥ 40mm:

Non-granular morphology:

Non-lifting / Previous Attempt:

Direct ileocaecal valve, diverticular or appendiceal involvement:

Definitions:

Hot Snare - colon polyp removed using a snare with use of electrosurgical energy
Diathermy - electrosurgical energy
Cold Snare - colon polyp removed using a snare without electrosurgical energy

Score Adapted for GIEQs.com by David Tate: