Laparoscopic Treatment of Colonic Polyps

In any large practice, some patients will be identified with polyps that are unable to be safely removed with a colono-scope. For those few polyps that cannot be endoscopically managed, laparoscopic techniques provide a safe and attrac-tive option. They have the potential to decrease patient dis-comfort and length of stay and still provide adequate onco-logic treatment of these potentially malignant lesions. well described, several components of the proce-dure are important when resectional therapy is per-formed for polyps. These include accurate lesion localization and the need to perform a potentially curative resection for polyps that contain invasive cancer on pathologic evaluation. Lesion Localization Endoscopic removal is the mainstay in the treat-ment of adenomas and other benign lesions of the colon. However, for a variety of reasons, whether size or location, a specific subset of polyps are not amenable to endoscopic resection. Previously, such lesions were removed by open colectomy. With the improvement and increased availability of advanced laparoscopic techniques, additional management options such as laparo-scopic assisted endoscopic polypectomy and la-paroscopic colectomy are now feasible. " 2 These pro-cedures allow for the potential benefits of minimal-ly invasive surgery with adequate lesion removal. In this paper, we describe these techniques and re-view the small, published experience of laparoscopic polyp management. Laparoscopic-Assisted Colectomy Laparoscopic colectomy is technically demanding but has been demonstrated as safe and feasible for a number of colorectal conditions. Although the techniques used in laparoscopic bowel resection ar