Difficult Polypectomy. To be too difficult to be removed endoscopically.? Generally some criteria are acceptable that Which Patients Should Be Treated Initially With Surgical Resection (1) polyps that laterally encompass more than one third of the bowel circumference; (2) those that extend longitudinally over 2 successive haustral folds; (3) lesions that grossly appear to be malignant (eg, irregular, friable, firm/hard, ulcerated, bleeding); and (4) polyps that extend into the appendix, a diverticulum, or the ileocecal valve, or otherwise wrap around a sharp fold.
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