Laparoscopic-assisted colonoscopic polypectomy: a review

The majority of colon polyps encountered on endoscopy are resected via diathermy snare, which is the most commonly performed therapeutic intervention in colonoscopy. Endoscopic polypectomy can be unsafe when performed on larger polyps or polyps in difficult locations. Polypectomy of these lesions are a risk for perforation, difficulty obtaining clear margins, incomplete sampling due to piecemeal resection, recurrence and histologic misdiagnosis. Such lesions prompt either open or laparoscopic segmental colectomy with inherent risks of major colon resection such as anastomotic leaks and other postoperative complications. Laparoscopic-assisted colonoscopic polypectomy (LACP) is an established alternative to partial colectomy for resection of large, inaccessible, or sessile colon polyps. Laparoscopy facilitates polypectomy by enhancing endoscopic positioning via colonic mobilization and manipulation. This method provides a hybrid technique for resection of benign lesions that complements the strengths of laparoscopy and endoscopy for a minimally invasive surgical technique with good outcomes and low risk. This is a review of the literature regarding the indications, technique, benefits and drawbacks, and postoperative care, and complications of LACP.