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Dynamic Article: Full-Thickness Excision for Benign Colon Polyps Using Combined Endoscopic Laparoscopic Surgery.

Anthony Y Lin1, Paul R A O'Mahoney, Jeffrey W Milsom

  • 11 Division of Colorectal Surgery, Department of Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York 2 Department of Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York 3 Division of Colorectal Surgery, Department of Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California.

Diseases of the Colon and Rectum
|December 10, 2015
PubMed
Summary

A new full-thickness excision technique for difficult benign colon polyps, combined with endoscopy and laparoscopy, proved safe and feasible. This approach allows removal of challenging polyps, potentially avoiding colectomy.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Benign colon polyps can be difficult to remove endoscopically due to size, shape, location, or scarring.
  • Existing combined endoscopic and laparoscopic techniques have limitations for polyps with poor lifting.
  • A novel full-thickness approach is presented to enhance polyp maneuverability and local excision.

Purpose of the Study:

  • To report the technical details and preliminary outcomes of a new combined endoscopic laparoscopic surgery full-thickness excision technique.
  • To evaluate the safety and feasibility of this approach for difficult-to-resect benign colon polyps.

Main Methods:

  • Retrospective review of three patients undergoing combined endoscopic laparoscopic surgery-full-thickness excision from December 2013 to May 2015.
  • Patients had benign-appearing polyps unsuitable for traditional endoscopic or combined laparoscopic methods due to morphology or scarring.
  • Safety and feasibility were the primary outcome measures.

Main Results:

  • Three patients were successfully treated with the combined endoscopic laparoscopic surgery-full-thickness excision technique.
  • No intraoperative or postoperative complications were observed.
  • All patients experienced a 1-day length of stay and had benign final pathology.

Conclusions:

  • Combined endoscopic laparoscopic surgery-full-thickness excision is a safe and feasible option for difficult benign colon polyps.
  • This technique enables the removal of polyps not amenable to standard endoscopic procedures.
  • Colectomy may be avoided in select cases using this advanced surgical approach.