Endoscopic Management of Polyps, Polypectomy, and Combined Endoscopic and Laparoscopic Surgery
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Polypectomy is fundamental to the practice of colonoscopy. Polypectomy disrupts the adenoma to carcinoma sequence, thereby reducing colorectal cancer incidence and mortality. The goals of polypectomy are the effective, safe, and efficient removal of precancerous polyps while minimizing the risk of complications. Recent advances in endoscopic techniques such as endoscopic mucosal resection and endoscopic submucosal dissection can ensure complete and safe resection of lesions and evade surgery in some patients. Combined endo-laparoscopic surgery is an adjunct to endoscopic polypectomy that may help to avoid colectomy. Although polyp removal using these advanced techniques may be an effective alternative in select patients, they require both experience and expertise to become an available option in a surgeon’s armamentarium.
KeywordsColon polyp Adenoma Colonoscopy Polypectomy Colon biopsy Adenoma Endoscopic mucosal resection Endoscopic submucosal dissection Combined endo-laparoscopic surgery
Combined endo-laparoscopic surgery for removal of a polyp. Courtesy of Sang Lee, MD. (MP4 331763 kb)