Hybrid Laparoendoscopic Approaches to Endoscopically Unresectable Colon Polyps

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Colorectal cancer secondary prevention relies on colonoscopy and polypectomy.
• Large, flat, or obscured polyps pose technical challenges for endoscopic resection.
• Radical colectomy may be required for difficult polyp removal, impacting patient outcomes.

Purpose of the Study:

• To review hybrid laparoendoscopic techniques for managing challenging colorectal polyps.
• To evaluate these techniques as alternatives to segmental colectomy.
• To highlight the benefits of combined laparoscopic and endoscopic approaches.

Main Methods:

• Review of literature on hybrid laparoendoscopic techniques for polyp resection.
• Description of various techniques: laparoscopic-assisted colonoscopic polypectomy, colonoscopy-assisted laparoscopic resection, and laparoscopic-assisted endoscopic full-thickness resection (EFTR).
• Comparison of these techniques with traditional colonoscopy and colectomy.

Main Results:

• Hybrid techniques offer solutions for difficult polyps, avoiding extensive colectomies.
• Laparoscopic-assisted colonoscopic polypectomy is a frequently used method.
• Laparoscopic-assisted EFTR is a newer technique with endoscopic defect closure.
• Minimally invasive colectomy remains an option for suspected malignancy or unsuitable cases.

Conclusions:

• Combined laparoscopy and endoscopy expand treatment options for challenging colorectal polyps.
• These hybrid approaches limit the extent of colon resection, benefiting patients.
• Minimally invasive strategies enhance the management of polyps during colorectal cancer screening and prevention.