Colonic adenomas are commonly encountered lesions that are a precursor of colorectal cancer. Of these, villous adenomas are a rarer, more advanced subtype that are larger in size than tubular adenomas and have a higher risk of malignant transformation. We present a patient with a giant villous adenoma of the sigmoid colon identified on CT as homogeneous segmental bowel wall thickening.

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Laparoscopic surgery is now popular in the field of hepatopancreato-biliary (HPB) surgery. Laparoscopic Ultrasonography (LUS) is more familiar to surgeons than other doctors because abdominal anatomy is well understood by them. Furthermore, combination of laparoscopy and ultrasonography in the operating theater can be a distinguishable tool for surgeons.Between July 2009 and December 2018, we performed 521 Intra-operative ultrasonography at Bucheon St. Mary Hospital, Catholic University of Korea. LUS underwent 195 in HPB patients. The patients were liver malignancies (18), liver benign lesions(26), Gallstones and suspicious common bile duct stones (62), Gallbladder cancer (5), gallbladder benign disease(63), malignancy staging and biopsy (11) and pancreatic lesions(10).LUS is usable for detection of tumor, discern relation of tumor with its surrounding tissue, determine resectability and to perform surgical procedures. LUS gives more information to the performing surgeon that generally leads to a better outcome. With LUS, surgeons can detect more additional nodules than conventional radiologic techniques. LUS makes surgeons available to detect unknown lesions, find out its characteristics and gather more information on surrounding vascular structures. LUS is also used in guided procedures.After learning the LUS technique, HPB surgeon are able to provide optimal care for their patients by using the LUS. We conclude that the use of LUS is a minimal, less time consuming and highly accurate method during HPB surgery. HBP surgeons are not only capable of utilizing LUS skillfully, but also of developing numerous applications.