Laparoscopic-assisted coloscopic polypectomy

PURPOSE: Patients with colorectal polyps often display a large kink or dist inct mucosal fold in the area where the polypectomy is to take place. As a result, there is a higher risk of perforation or partial ablation during an endoscopic polypectomy. Is it safer to perform an endoscopic polypectomy u sing the control and assistance of a laparoscope? Can a segment resection o f the colon that would otherwise be necessary be avoided? METHODS: An endos copic polypectomy using a laparoscope was conducted on six patients whose c olorectal polyps were in an anatomically unfavorable location. The need for an open or laparoscopic segment resection or colotomy was indicated in all cases. The growth was located in die rectosigmoidal transition in five pat ients and in the region of the left flexure in one patient. We decided that an endoscopic polypectomy using the assistance of a laparoscope would be t he most comfortable and technically elegant method, as well as easy. Except the well-known risks of laparoscopy and endoscopic polypectomy, no other r isks have been seen in our patients. The affected area of the colon, the si gma, and the left flexure were mobilized and stretched as much as possible to enable a simultaneous and low-risk endoscopic polypectomy. In one case, we had to conduct a fractionated ablation because of a very wide-based find ing. RESULTS: The operation averaged 57 minutes, and no operation-specific complications were observed. Postoperative recovery in the hospital was ver y short and averaged 2.5 days. The histopathologic findings were benign in all cases, but a serious dysplasia was diagnosed in one patient. CONCLUSION S: The laparoscopic-assisted polypectomy is a safe method to remove even co mplicated polyps in anatomically unfavorable locations.