Advertisement

Combined Endoscopic and Laparoscopic Surgery (CELS)

  • Kelly A. Garrett
  • Sang W. LeeEmail author
Chapter

Abstract

Colonoscopic polypectomy is the treatment of choice for diagnosing and removing most colon polyps. Large polyps or those in an anatomically difficult location can be very challenging to remove by endoscopic techniques alone. Traditionally, the most common recommendation for these patients has been to undergo a subsequent colon resection. Although the laparoscopic approach has reduced the morbidity of an abdominal operation, potential morbidities related to bowel resection still need to be considered. A combined approach using both laparoscopy and colonoscopy (combined endoscopic and laparoscopic surgery, CELS) has been described as an alternative to bowel resection in select patients with polyps that cannot be removed endoscopically. This procedure utilizes laparoscopic manipulation of the colon wall adjacent to the polyp to facilitate polypectomy. Furthermore, it enables prompt diagnosis and treatment of full-thickness defects of the colon and provides an opportunity to proceed with a standard oncological resection for lesions that are not amenable or suitable for CELS.

Keywords

Laparoscopic-assisted endoscopic polypectomy Combined laparo-endoscopic surgery Endo-laparoscopic surgery CELS Benign polyps 

Supplementary material

Videos 18.1

Combined endoscopic and laparoscopic surgery (WMV 159823 kb)

Videos 18.2

Combined endoscopic and laparoscopic surgery (WMV 231411 kb)

References

  1. 1.
    Fujishiro M, Goto O, Kakushima N, Kodashima S, Muraki Y, Omata M. Endoscopic submucosal dissection of stomach neoplasms after unsuccessful endoscopic resection. Dig Liver Dis. 2007;39(6):566–71.CrossRefPubMedGoogle Scholar
  2. 2.
    Zhou PH, Yao LQ, Qin XY. Endoscopic submucosal dissection for colorectal epithelial neoplasm. Surg Endosc. 2009;23(7):1546–51.CrossRefPubMedGoogle Scholar
  3. 3.
    Franklin Jr ME, Diaz-E JA, Abrego D, Parra-Davila E, Glass JL. Laparoscopic-assisted colonoscopic polypectomy: the texas endosurgery institute experience. Dis Colon Rectum. 2000;43(9):1246–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Beck DE, Karulf RE. Laparoscopic-assisted full-thickness endoscopic polypectomy. Dis Colon Rectum. 1993;36(7):693–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Guller U, Jain N, Hervey S, Purves H, Pietrobon R. Laparoscopic vs open colectomy: outcomes comparison based on large nationwide databases. Arch Surg. 2003;138(11):1179–86.CrossRefPubMedGoogle Scholar
  6. 6.
    Ommer A, Limmer J, Mollenberg H, Peitgen K, Albrecht KH, Walz MK. Laparoscopic-assisted colonoscopic polypectomy—indications and results. Zentralbl Chir. 2003;128(3):195–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Lee SW, Garrett KA, Shin JH, Trencheva K, Sonoda T, Milsom JW. Dynamic article: long-term outcomes of patients undergoing combined endolaparoscopic surgery for benign colon polyps. Dis Colon Rectum. 2013;56(7):869–73.CrossRefPubMedGoogle Scholar
  8. 8.
    Lee MK, Chen F, Esrailian E, et al. Combined endoscopic and laparoscopic surgery may be an alternative to bowel resection for the management of colon polyps not removable by standard colonoscopy. Surg Endosc. 2013;27(6):2082–6.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Yan J, Trencheva K, Lee SW, Sonoda T, Shukla P, Milsom JW. Treatment for right colon polyps not removable using standard colonoscopy: combined laparoscopic-colonoscopic approach. Dis Colon Rectum. 2011;54(6):753–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Wilhelm D, von Delius S, Weber L, et al. Combined laparoscopic-endoscopic resections of colorectal polyps: 10-year experience and follow-up. Surg Endosc. 2009;23(4):688–93.CrossRefPubMedGoogle Scholar
  11. 11.
    Franklin Jr ME, Leyva-Alvizo A, Abrego-Medina D, et al. Laparoscopically monitored colonoscopic polypectomy: an established form of endoluminal therapy for colorectal polyps. Surg Endosc. 2007;21(9):1650–3.CrossRefPubMedGoogle Scholar
  12. 12.
    Winter H, Lang RA, Spelsberg FW, Jauch KW, Huttl TP. Laparoscopic colonoscopic rendezvous procedures for the treatment of polyps and early stage carcinomas of the colon. Int J Colorectal Dis. 2007;22(11):1377–81.CrossRefPubMedGoogle Scholar
  13. 13.
    Feussner H, Wilhelm D, Dotzel V, Papagoras D, Frimberger E. Combined endoluminal and endocavitary approaches to colonic lesions. Surg Technol Int. 2003;11:97–101.PubMedGoogle Scholar
  14. 14.
    Mal F, Perniceni T, Levard H, Boudet MJ, Levy P, Gayet B. Colonic polyps considered unresectable by endoscopy. Removal by combinations of laparoscopy and endoscopy in 65 patients. Gastroenterol Clin Biol. 1998;22(4):425–30.PubMedGoogle Scholar
  15. 15.
    Le Picard P, Vacher B, Pouliquen X. Laparoscopy-assisted colonic polypectomy or how to be helped by laparoscopy to prevent colectomy in benign colonic polyps considered to be unresectable by colonoscopy. Ann Chir. 1997;51(9):986–9.PubMedGoogle Scholar
  16. 16.
    Franklin Jr ME, Portillo G. Laparoscopic monitored colonoscopic polypectomy: long-term follow-up. World J Surg. 2009;33(6):1306–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Nakajima K, Lee SW, Sonoda T, Milsom JW. Intraoperative carbon dioxide colonoscopy: a safe insufflation alternative for locating colonic lesions during laparoscopic surgery. Surg Endosc. 2005;19(3):321–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Hamdani U, Naeem R, Haider F, et al. Risk factors for colonoscopic perforation: a population-based study of 80118 cases. World J Gastroenterol. 2013;19(23):3596–601.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Colorectal Surgery, Department of SurgeryNew York Presbyterian HospitalNew YorkUSA
  2. 2.Department of Surgery - Colon and Rectal SurgeryKeck School of Medicine of University of Southern CaliforniaLos AngelesUSA

Personalised recommendations