[Laparoscopic-assisted colonoscopic polypectomy--indications and results]

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Colorectal Surgery

Background:

• Endoscopic polypectomy for large, sessile, or awkwardly located polyps, particularly in the sigmoid colon or cecum, carries a significant risk of colonic perforation.
• Traditional surgical interventions for such polyps can be invasive and associated with higher morbidity.

Purpose of the Study:

• To evaluate the efficacy and safety of a combined colonoscopic-laparoscopic approach as an alternative for treating large, sessile, or awkwardly localized colonic polyps.
• To present this novel technique as a viable option to reduce the risks associated with conventional endoscopic or open surgical methods.

Main Methods:

• A cohort of 23 patients underwent laparoscopic-assisted colonoscopic polypectomy between 1995 and an unspecified date.
• The procedure involved general anesthesia, laparoscopy for visualization and stabilization, followed by endoscopic polyp removal under laparoscopic guidance.
• Laparoscopic interventions included colon wall stabilization, adhesiolysis, and suturing of any iatrogenic lesions.

Main Results:

• Laparoscopic-assisted polypectomy was successfully performed in 17 patients.
• Two patients required colotomy, and two others underwent segmental colonic resection due to large polyp size.
• Two patients with confirmed carcinoma underwent secondary laparoscopic-assisted left hemicolectomy; no intra- or perioperative complications were reported.

Conclusions:

• Laparoscopic-assisted colonoscopic polypectomy is a novel, minimally invasive therapeutic option for selected patients with large, sessile, or awkwardly positioned colonic polyps.
• This technique expands the possibilities for endoscopic management, potentially avoiding the need for colotomy or segmental resection.
• The added discomfort from laparoscopy in this combined approach is minimal, suggesting a favorable patient experience.