That White Thing You See After Cold Snaring

Cold snaring has become increasingly popular as an effective and safe way to remove polyps 5 mm and smaller in size, and its use is extended by many practitioners for removing polyps up to 7 to 10 mm in size, depending on polyp shape. After cold snaring, the mucosal defect sometimes shows a protrusion or cord of white tissue in the middle of the mucosal defect. Clinicians are sometimes concerned that this cord of white tissue represents a blood vessel or residual polyp.

In a prospective, observational study of cold snare polypectomies, colonoscopists removed 257 consecutive polyps ≤10 mm in size (63% adenomas; mean size, 5.5 mm), identifying the white submucosal protrusion or cord in 36 polypectomies (14%). Biopsy of this tissue revealed sub…