The Complex Polyp Service manages patients who have a polyp or multiple polyps seen on a colonoscopy, flexible sigmoidoscopy or CT scan that require a higher level of endoscopy skill to remove the lesion.

The term complex polyp refers to a colon or rectal polyp that can be more challenging to remove than most polyps typically encountered on colonoscopy. Features of a complex polyp include:

  • Large size (greater than two centimetres)
  • Difficult-to-reach location
  • Very flat shape.

The complex polyp team comprises of highly specialised endoscopists, colorectal surgeons, specialist nurses and administrators.

We are the only supra-regional level four centre, for Merseyside and Cheshire and take referrals locally, throughout the region and Wales. We also take referrals from a number of local and regional cancer multidisciplinary meetings.

More information

Patients are usually referred from their local hospital with any of the below findings on endoscopy:

  • SMSA Score >9
  • Lesion at the Appendiceal orifice (regardless of SMSA score)
  • Lesion at the ICV (regardless of SMSA score)
  • Recurrent polyps (regardless of SMSA score)
  • Polyps at high risk of cancer (regardless of SMSA score)
  • Disrupted pit pattern (pit pattern v)
  • Histology with on biopsy HGD
  • LST-NG or LST-G with nodules.