Figure 1 Polyp arising from within a diverticulum.

A 64-year-old man was referred because of a history of colon polyps. He had undergone colonoscopy 7 years earlier, which included removal of a tubular adenoma and a finding of diverticulosis. He then underwent a colonoscopy at our facility, which included removal of a 10-mm tubular adenoma and two 10-mm tubulovillous adenomas. An additional 10-mm sessile polyp was found inside a diverticulum in the transverse colon; this polyp initially only underwent biopsy and was found to be a tubular adenoma. He returned for a repeat colonoscopy for removal of this transverse colon polyp. The polyp could not be safely lifted or snared because the majority of the polyp was inside a diverticulum. Initially, the polyp and surrounding diverticulum were suctioned into a cap and banded by using an EMR device. Next, an over-the-scope clip was deployed around the banded polyp under the rubber band. Finally, the polyp was removed with hot snare performed above the clip. The patient did well after the procedure and had no adverse events. Final pathology revealed a tubular adenoma with attached muscularis propria and adjacent adipose tissue ( Fig. 1 Video 1 , available online at www.giejournal.org ).