LAPAROSCOPY-ASSISTED COLONIC POLYPECTOMY, OR HOW TO USE LAPAROSCOPY TO AVOID COLECTOMY FOR BENIGN COLONIC POLYPS CONSIDERED TO BE UNRESECTABLE BY COLONOSCOPY

The aim of this study was to prospectively evaluate the role of laparo scopic surgery in all patients presenting with colonic polyps. From Ap ril 1994 to April 1996, 16 consecutive patients were treated. The lapa roscopy starts the procedure, then a colonoscopy easily and rapidly lo cates the colonic lesion. Under laparoscopic supervision a new snare p olypectomy is often possible. If polypectomy remains impossible, a min i-laparotomy is performed above the polyp and allows polypectomy by ex tra-peritoneal colotomy. In one case, the polyp was not found on colon oscopy. Colonoscopic polypectomy was possible in 6 cases (40 %), and 9 mini-laparotomies were necessary (60 %). No colectomy was performed. The final histologic result showed two Dukes A carcinomas justifying s econdary wide colectomy. Laparo-assisted polypectomy is a safe and eff icient procedure, allows complete excision of polyps and may avoid a c olonic resection.