Abstract
Colonoscopic polypectomy is the treatment of choice for diagnosing and removing most colon polyps. Large polyps or those in an anatomically difficult location can be very challenging to remove by endoscopic techniques alone. Traditionally, the most common recommendation for these patients has been to undergo a subsequent colon resection. Although the laparoscopic approach has reduced the morbidity of an abdominal operation, it still poses potential morbidities related to bowel resection. A combined approach using both laparoscopy and colonoscopy (combined endo-laparoscopic surgery, CELS) has more recently been described as an alternative to bowel resection in select patients with polyps that cannot be removed endoscopically. This procedure allows laparoscopic manipulation of the colon wall adjacent to the polyp to facilitate polypectomy. Furthermore, it enables prompt diagnosis and treatment of full-thickness defects of the colon and provides an opportunity to proceed with a standard oncological resection in lesions that are not amenable or suitable for this CELS. In this chapter, we will review this technique including key points for success.
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References
Fujishiro M, Goto O, Kakushima N, Kodashima S, Muraki Y, Omata M. Endoscopic submucosal dissection of stomach neoplasms after unsuccessful endoscopic resection. Dig Liver Dis. 2007;39(6):566–71.
Zhou PH, Yao LQ, Qin XY. Endoscopic submucosal dissection for colorectal epithelial neoplasm. Surg Endosc. 2009;23(7):1546–51.
Franklin Jr ME, Diaz-E JA, Abrego D, Parra-Davila E, Glass JL. Laparoscopic-assisted colonoscopic polypectomy: the Texas Endosurgery Institute experience. Dis Colon Rectum. 2000;43(9): 1246–9.
Beck DE, Karulf RE. Laparoscopic-assisted full-thickness endoscopic polypectomy. Dis Colon Rectum. 1993;36(7):693–5.
Guller U, Jain N, Hervey S, Purves H, Pietrobon R. Laparoscopic vs open colectomy: outcomes comparison based on large nationwide databases. Arch Surg. 2003;138(11):1179–86.
Ommer A, Limmer J, Mollenberg H, Peitgen K, Albrecht KH, Walz MK. Laparoscopic-assisted colonoscopic polypectomy—indications and results. Zentralbl Chir. 2003;128(3):195–8.
Lee SW, Garrett KA, Shin JH, Trencheva K, Sonoda T, Milsom JW. Dynamic article: long-term outcomes of patients undergoing combined endolaparoscopic surgery for benign colon polyps. Dis Colon Rectum. 2013;56(7):869–73.
Lee MK, Chen F, Esrailian E, et al. Combined endoscopic and laparoscopic surgery may be an alternative to bowel resection for the management of colon polyps not removable by standard colonoscopy. Surg Endosc. 2013;27(6):2082–6.
Yan J, Trencheva K, Lee SW, Sonoda T, Shukla P, Milsom JW. Treatment for right colon polyps not removable using standard colonoscopy: combined laparoscopic-colonoscopic approach. Dis Colon Rectum. 2011;54(6):753–8.
Wilhelm D, von Delius S, Weber L, et al. Combined laparoscopic-endoscopic resections of colorectal polyps: 10-year experience and follow-up. Surg Endosc. 2009;23(4):688–93.
Franklin Jr ME, Leyva-Alvizo A, Abrego-Medina D, et al. Laparoscopically monitored colonoscopic polypectomy: an established form of endoluminal therapy for colorectal polyps. Surg Endosc. 2007;21(9):1650–3.
Winter H, Lang RA, Spelsberg FW, Jauch KW, Huttl TP. Laparoscopic colonoscopic rendezvous procedures for the treatment of polyps and early stage carcinomas of the colon. Int J Colorectal Dis. 2007;22(11):1377–81.
Feussner H, Wilhelm D, Dotzel V, Papagoras D, Frimberger E. Combined endoluminal and endocavitary approaches to colonic lesions. Surg Technol Int. 2003;11:97–101.
Mal F, Perniceni T, Levard H, Boudet MJ, Levy P, Gayet B. Colonic polyps considered unresectable by endoscopy. removal by combinations of laparoscopy and endoscopy in 65 patients. Gastroenterol Clin Biol. 1998;22(4):425–30.
Le Picard P, Vacher B, Pouliquen X. Laparoscopy-assisted colonic polypectomy or how to be helped by laparoscopy to prevent colectomy in benign colonic polyps considered to be unresectable by colonoscopy. Ann Chir. 1997;51(9):986–9.
Franklin Jr ME, Portillo G. Laparoscopic monitored colonoscopic polypectomy: long-term follow-up. World J Surg. 2009;33(6): 1306–9.
Nakajima K, Lee SW, Sonoda T, Milsom JW. Intraoperative carbon dioxide colonoscopy: a safe insufflation alternative for locating colonic lesions during laparoscopic surgery. Surg Endosc. 2005; 19(3):321–5.
Hamdani U, Naeem R, Haider F, et al. Risk factors for colonoscopic perforation: a population-based study of 80118 cases. World J Gastroenterol. 2013;19(23):3596–601.
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Garrett, K.A., Lee, S.W. (2015). Combined Endo-Laparoscopic Surgery (CELS). In: Ross MD FACS FASCRS, H., Lee MD, FACS, FASCRS, S., Mutch MD, FACS, FASCRS, M., Rivadeneira MD, MBA,FACS, FASCRS, D., Steele M.D., FACS, FASCRS, S. (eds) Minimally Invasive Approaches to Colon and Rectal Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1581-1_26
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DOI: https://doi.org/10.1007/978-1-4939-1581-1_26
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