Combined Endoscopic and Laparoscopic Surgery (CELS)
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.
KeywordsLaparoscopic-assisted endoscopic polypectomy Combined laparo-endoscopic surgery Endo-laparoscopic surgery CELS Benign polyps
Combined endoscopic and laparoscopic surgery (WMV 159823 kb)
Combined endoscopic and laparoscopic surgery (WMV 231411 kb)