Fry LC et al. (2006) Diagnostic quality of polyps resected by snare polypectomy: does the type of electrosurgical current used matter? Am J Gastroenterol 101: 2123–2127

An adequate histologic evaluation of resected colorectal polyps is essential for deciding on the optimal postpolypectomy therapy or surveillance method; it is, therefore, important that the resected tissue is of sufficient quality for evaluation. The diagnostic quality of resected polyps might be affected by the specific electrosurgical resection technique used for polypectomy, although there are limited data comparing the diagnostic quality of specimens yielded by polypectomy using different electrosurgical devices.

Fry et al. have compared the diagnostic quality of polyps resected with a conventional electrosurgical generator (ESG) that used a blended electrical current (n = 78), with those removed using Endo Cut® (ERBE Inc., Marietta, GA USA), an ESG with a microprocessor that allows automatic control of cutting and coagulation modes (n = 70).

The total area of cautery and the degree of cautery damage (based on the cell and tissue response) was reduced for polyps resected using Endo Cut®, and polyp margins could be more easily evaluated with this device than with the conventional ESG. Overall, polyps resected using Endo Cut® were of markedly superior quality for histologic evaluation. The architecture of the resected tissue was similar in polyps resected by either technique.

The authors conclude that Endo Cut® allows for improved histologic interpretation of polyp specimens; they highlight the need for prospective, randomized trials to compare the various types of electrosurgical techniques used for polypectomy.