Adenoma resection is the surgical removal of an adenoma, a benign, but often pre-cancerous, glandular tumour arising from epithelial tissue. Adenomas can cause serious complications depending on their size and location even if non-cancerous.
One of the most common forms is pituitary adenoma resection, where surgeons remove tumours from the pituitary gland using minimally invasive transsphenoidal surgery through the nasal cavity.
These tumours can affect hormone regulation and compress nearby structures, such as the optic nerves, leading to symptoms including vision loss, headaches, and endocrine disorders. In the gastrointestinal tract, adenoma resection is frequently performed during advanced endoscopic procedures to remove colorectal polyps or duodenal adenomas.
Rising surgical intervention
In pituitary surgery, surgeons operate through narrow nasal corridors to access the sella turcica, often working around the optic nerves and carotid arteries. In gastrointestinal procedures such as endoscopic mucosal resection or duodenal interventions, devices must move through sharply angled pathways while maintaining control and visibility.
During a colonoscopy, suspicious polyps are cut off using snares for later testing. Cancerous polyps then might lead to surgical intervention, including resection, to remove the diseased tissue. These interventions are rising steadily as healthcare settings see more instances of colorectal cancer (CRC).
Across the eight markets tracked by GlobalData market intelligence, which include the US, EU, UK, Japan and China, 1.1 million cases of colorectal cancer were diagnosed in 2025, with expectations that this could reach 1.3 million by 2031[i].
The technical challenges of treating a flat adenoma
Success in adenoma resection depends on navigating difficult anatomy and removing tissue accurately without damaging surrounding structures.
The earlier an adenoma is detected the better for patient outcome, and with 4K-resolution capable imaging, subtle tissue differentiation is easier to recognise, so clinicians are increasingly able to spot colorectal lesions early before they morph into polyps. If left, they can cause disorders and lead to malign symptoms for the patient. But handling a flat adenoma can be much more of a technical challenge than when it becomes a polyp. Removing a flat lesion is fundamentally different from performing a routine polypectomy.
Tom Schmid, Global Product Manager, Flexible Instruments at Alleima’s medical unit explains. “A polyp presents a clear three-dimensional target. It protrudes into the lumen, giving the physician something to capture and ‘lasso’ with a conventional snare.
“A flat adenoma, by contrast, sits close to or in the mucosal surface with minimal elevation and less-defined edges. There is often no natural stalk or cap to encircle, and the working margin between target tissue and surrounding structures can be smaller.
“As a result, clinicians typically need additional steps to create a resectable geometry.”
Schmid says one approach is to use a hook-style instrument to make small incisions around the lesion, then inject fluid via water jet to lift the tissue, effectively creating an artificial elevation so the lesion can be removed. “But compared with a standard polyp snare, this can be more time-intensive and requires repeated, careful manual actions to progressively separate tissue.”
Why standard snares can be limiting
With a conventional, uninsulated wire loop, energy can be released across larger portions of the snare. In a flat resection scenario, where the physician is working close to the wall and aiming to avoid affecting deeper layers, uncontrolled energy distribution can make it more difficult to confine the effect to the intended cutting points.
To solve this challenge, Alleima has introduced a flat adenoma resection instrument design with an almost entirely in insulated snare, leaving only a few millimetres at the distal tip uninsulated. In practical terms, that means the instrument is designed to concentrate energy delivery at specific, localised areas rather than across the full loop.
The distal end also incorporates a small cap feature intended to ensure the snare bends rather than presses into tissue, supporting controlled interaction with the mucosal surface. By combining insulation with a design that guides distal behaviour, the concept aims to help clinicians perform the key resection step more efficiently, moving away from extensive, repetitive micro-incisions and toward a snare-based removal approach once the lesion has been prepared and lifted.
A partner-ready innovation model for OEMs
For OEMs, the significance extends beyond a single device. As minimally invasive procedure needs evolve, Alleima offers materials expertise combined with developed instrument concepts that are ready to be adapted. Alleima is a specialist in advanced metallurgy and state-of-the-art medical fine-wire and nitinol technologies. With its vertically integrated manufacturing capabilities Alleima supports global medical device innovators seeking novel and differentiated solutions for next-generation endoscopic interventions
To explore how nitinol is revolutionising healthcare and how Alleima supports medical OEMs in developing next-generation technology, materials and solutions for optimum patient care, download the report below.
[i] GlobalData Pharmaceutical Intelligence Centre, Colorectal Cancer: Eight-Market Drug Forecast and Market Analysis
