What is indicated if a polyp cannot be constricted by the snare before activation?

When a polyp cannot be constricted by the snare before activation, it suggests that the polyp's dimensions or characteristics are such that it might not be amenable to being removed in one piece. This is a critical observation because it points to the possibility that the polyp is either too wide or has a significant base that prevents successful capture with the snare.

In such cases, opting for piecemeal excision becomes a viable and often necessary alternative. This technique allows the surgeon to remove the polyp in smaller sections, reducing the risk of incomplete resection and ensuring better retrieval of tissue for histopathological evaluation. A piecemeal approach can also mitigate complications associated with larger polyps, including perforation or excessive bleeding.

Understanding the specific circumstances under which a polyp cannot be constricted helps guide the choice of removal techniques, enhancing patient safety and surgical outcomes.