Rationale and selection of patients for combined procedures in dysplastic colonic lesions and T1 carcinoma

Combined endoscopic-laparoscopic procedures may offer an interesting therap eutic option in cases of benign colonic lesions and early T 1 carcinoma whe re endoluminal resection is not feasible, but oncological resection is not (yet) required. Combined procedures such as the laparoscopically assisted e ndoscopic resection, the endoscopically assisted laparoscopic wedge or tran sluminal resection, or the segmental resection can be performed. Experience with this technique is still limited, but has shown that the invasiveness can be reduced by endoscopically guided local excision. If it is possible t o keep the incidence of secondary operations low, combined laparoscopic/end oscopic interventions could occupy a valuable place in the therapeutic spec trum.