Combined endo-laparoscopic surgery for difficult benign colorectal polyps

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Colorectal cancer (CRC) prevention relies on detecting and removing polyps.
• 10-15% of colorectal polyps are difficult to treat endoscopically due to size, morphology, location, scarring, or recurrence.
• Traditional surgical resection carries significant risks and morbidities for these difficult polyps.

Purpose of the Study:

• To review the application of combined endoscopic and laparoscopic surgery (CELS) for difficult benign colorectal polyps.
• To highlight CELS as an alternative to traditional surgical resection for challenging polyp cases.

Main Methods:

• Review of current CELS techniques for difficult benign colorectal polyps.
• Discussion of laparoscopy-assisted endoscopic polypectomy (LACP).
• Discussion of full-thickness laparo-endoscopic excision (FLEX).
• Discussion of colonoscopy-assisted laparoscopic wedge resection (CAL-WR).

Main Results:

• CELS techniques are being developed to manage difficult benign colorectal polyps.
• These methods aim to reduce the need for extensive surgical resection.
• Specific CELS approaches like LACP, FLEX, and CAL-WR are detailed.

Conclusions:

• Combined endoscopic and laparoscopic surgery (CELS) provides a viable option for difficult benign colorectal polyps.
• CELS offers a way to manage complex polyps while balancing operative risks.
• Further evaluation of LACP, FLEX, and CAL-WR is important for optimizing treatment strategies.