Combined Endoscopic Laparoscopic Surgery Procedures for Colorectal Surgery

Abstract

Colonoscopy is the standard of care for screening and surveillance of colorectal cancers. Removal of adenomatous polyps prevents the transformation of adenomas to potential adenocarcinoma. While most polyps are amenable to simple endoscopic polypectomy, difficult polyps that are large, broad-based, or located in haustral folds or in tortuous colon segments can present a challenge for endoscopists. Traditionally, patients with endoscopically unresectable polyps have been referred for oncologic surgical resection due to the underlying risk of malignancy within the polyp; however, the majority of these polyps are benign on final pathology. Combined endoscopic laparoscopic surgery can help facilitate endoscopic removal of difficult lesions, or allow the surgeon to select the correct laparoscopic approach for polyp excision. Current literature suggests that these procedures are safe and effective and can potentially save patients from the morbidity of laparotomy and segmental colectomy.

Combined Endoscopic Robotic Surgery for Complex Colon Polyps

“…2 Although most polyps can be resected with traditional endoscopic techniques, certain polyps are too challenging to remove by conventional methods because of characteristics including size >2 cm, broad-based morphology, or location in haustral folds and tortuous colonic segments. 3 Such complex polyps have historically been managed by formal surgical resection. Recent developments in new techniques include endoscopic mucosal resection (EMR), endoscopic submucosal dissection, and combined endoscopic and laparoscopic surgery (CELS).…”

Efficacy and safety of hybrid laparo-endoscopic surgery for colon tumors (systematic review and meta-analysis)

“…В представленном метаанализе проведена сравнительная оценка эффективности и безопасности гибридных лапаро-эндоскопических операций и лапароскопических резекций ободочной кишки при лечении пациентов с доброкачественными новообразованиями, неудалимыми эндоскопически. По данным большинства имеющихся в литературе публикаций, длительность операции и сроки пребывания пациентов в стационаре после гибридных лапаро-эндоскопических вмешательств оказались меньше, в сравнении с аналогичными показателями после лапароскопических сегментарных резекций толстой кишки [18][19][20]27,33], что подтверждается результатами исследований, включенных в данный метаанализ [16,17,24,28]. [2].…”

Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

“…(vii) Inadequate endoscopic access to the target lesion for EMR even by an expert in the technique [35] (laparoscopically assisted EMR or surgery) [36]. Level of agreement 84 %.…”