Table 1.

Reasons why the polyps were unsuitable for endoscopic mucosal resection (EMR) and which clinicians made this decision

Patient	Clinician deciding polyp(s) unsuitable for conventional EMR	Reason unsuitable for conventional EMR	Colonic resection required?
1	Senior gastroenterologist	30mm polyp in caecum - difficulty maintaining stable position	No
2	Author surgeon	25mm sessile polyp in caecum - difficulty maintaining stable position	Later right hemicolectomy - focus of malignancy in polyp
3	Senior gastroenterologist	35mm sessile ascending colon polyp	Conversion to resection - malignant looking polyp
4	Senior surgeon colleague	20mm caecal and 15mm hepatic flexure sessile polyps- perforation risk; surgeon had considered right hemicolectomy	No
5	Senior gastroenterologist	2 × polyps in caecum, one 40mm	No
6	Author surgeon	30mm sessile ascending colon polyp	No
7	Author surgeon	Previous attempted EMR for large polyp at hepatic flexure, remnant re-growth - needed adequate resection depth	No
8	Senior gastroenterologist	40mm sessile hemi-circumferential sigmoid polyp	No
9	Senior gastroenterologist	20mm sessile polyp behind fold in caecum - difficulty maintaining stable position	No
10	Senior gastroenterologist	Sessile, hemi-circumferential lesion in transverse colon covering 2 folds, laparo-endoscopic resection to straighten colon and maintain position	Conversion to transverse colectomy
11	Author surgeon	20mm sessile polyp behind fold in caecum - difficulty maintaining stable position	No
12	Author surgeon	50mm sessile lesion in caecum	Conversion to right hemicolectomy
13	Author surgeon	3 sessile polyps in ascending colon, largest 25mm	No