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Laparoscopic-assisted colonoscopic polypectomy: technique and preliminary experience
C Hensman1, A J Luck, P J Hewett
1Colorectal Unit, Department of Surgery, the Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, Adelaide, South Australia 5011, Australia.
Background:
The majority of colonic polyps found at endoscopy are suitable for diathermy snare excision via colonoscope. Due to location or size, some are deemed unsafe to treat in this manner and therefore require colectomy. This study describes the technique and early results of a laparoscopic-assisted colonoscopic polypectomy technique that can be used to manage such polyps and thereby avoid laparotomy and colectomy.
Methods:
Colonoscopy with simultaneous laparoscopy was utilized to locate the site of the polyp. The colon was mobilized, if required, and the polyp resected by electrosurgical snare via the colonoscope while the serosal aspect of the colon was monitored laparoscopically.
Results:
The technique has been tried successfully in six patients. Three polyps were in the cecum and three were within the left colon. The size of the polyps ranged from 3 to 7 cm. All polyps were benign on histological examination. The patients were discharged on the day following the procedure. There were no complications.
Conclusions:
The combination of laparoscopy with colonoscopic resection of a select group of large polyps represents a safe alternative to colonic resection.