Related Experiment Video
Updated: May 14, 2025
Author Spotlight: A Reproductive Hysteroscopy Approach for Complete Endometrial Polyp Removal and Enhanced Endometrial Receptivity
Published on: August 2, 2024
Laparoscopic-assisted Polypectomy: A Promising Minimally-invasive Solution for Endoscopically Irresectable Polyps in
Ayman Goneidy1, Andrew R Ross1, Rebecca Roberts1
1Chelsea and Westminster Hospital, London, SW10 9NH, UK.
Insights
Laparoscopic-assisted polypectomy (LAPT) safely removes difficult-to-reach intestinal polyps in children with Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS). This technique avoids the need for concurrent endoscopy or digital palpation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Oncology
Background:
- Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS) commonly present with small and large bowel polyps in children.
- Endoscopic or digital palpation methods may be insufficient or carry risks for certain polyp locations or sizes.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopic-assisted polypectomy technique (LAPT) in a pediatric tertiary center.
- To report the center's experience with LAPT for managing complex intestinal polyps in children.
Main Methods:
- A prospective review of pediatric patients (<18 years) who underwent LAPT over a 13-year period.
- Data collection included demographics, diagnosis, operative details, histopathology, complications, and follow-up.
- Exclusion criteria included patients over 18 years or those who had undergone endoscopic polypectomy.
Main Results:
- Seventeen pediatric patients (median age 12 years) underwent 19 LAPT procedures between 2011 and 2024.
- Fourteen patients had PJS, and 3 had JPS; polyps were unsuitable for standard endoscopic removal due to size, location, or perforation risk.
- LAPT was successful in all cases, with no conversions to open surgery, a median hospital stay of 5 days, and no late complications.
Conclusions:
- Laparoscopic-assisted polypectomy (LAPT) is an effective and safe surgical option for excising intestinal polyps in children, particularly those with PJS and JPS.
- LAPT offers a viable alternative to endoscopic methods for polyps with a higher risk of perforation, eliminating the need for concurrent endoscopy or digital palpation.
Aim Of The Study:
Small and large bowel polyps are commonly associated in children with Peutz-Jeghers syndrome (PJS) and juvenile polyposis Syndrome (JPS). A promising technique was described to identify polyps' locations laparoscopically without the need for concurrent endoscopy or digital palpation. The aim of this study is to report one center's experience in applying this laparoscopic-assisted polypectomy technique (LAPT).
Methods:
Prospective review of patients' records was performed for patients <18 years who underwent LAPT in a tertiary center over a 13-year period. Data collected included demographics, Diagnosis, post-operative complications, histopathology and follow-up. Patients >18 years and/or those who had endoscopic polypectomy were excluded.
Main Results:
Seventeen patients underwent 19 LAPs between 2011 and 2024 at a Median age of 12 years. M:F = 3:14. Fourteen patients presented with PJS and 3 presented with JPS. All Patients underwent endoscopic assessment and were considered unsuitable for advanced-skill polypectomy based on size, location or risk of perforation from invaginated muscularis mucosa. LAPT was performed in 15 patients and laparoscopic-assisted right hemicolectomy in 2 presenting with cecal polyps. Polyps were easily identified intra-operatively with associated serosal indentation or previous tattooing. There were no conversions to open. Histopathology was benign, except in one JPS patient who had Tubulo-villous adenoma. Median hospital stay was 5 days. Patients were followed-up 6-8 weeks post-operatively and had no late complications.
Conclusions:
LAPT is efficient and safe for excision of intestinal polyps that have a higher perforation risk if removed endoscopically. It eliminates the need for concurrent endoscopy or digital palpation.
More Related Videos
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:26Endoscopic Procedures V: ERCP
Patient...