Surgeons often excise entire sections of the colon when it contains large, difficult-to-remove polyps, but a new minimally invasive technique presented last week at Digestive Disease Week promises to shorten procedure times, hospital stays and patient recoveries.
Instead of using a laparoscope to remove colon segments during laparoscopic hemicolectomy (LHC), surgeons can also employ an endoscope to target and remove only the polyp during a procedure called laparoscopic-assisted colonoscopy with polypectomy (LACP), according to Jonathan Buscaglia, MD, the director of advanced endoscopy at Stony Brook (N.Y.) University School of Medicine.
Overall, the dual technique achieves comparable outcomes with similar complication rates, says Dr. Buscaglia. However, he notes, it also slashes operative times from nearly 2 hours to 1.5 hours. Additionally, patients lose 50ml less blood and needed 1L less of fluid post-op. They resume eating solid foods within 2 days of surgery compared with the 4 days LHC patients have to wait. These factors readied LACP patients for discharge 1.5 days sooner than patients who undergo LHC.
A significant number of the approximately 25% of colonoscopy patients who require polyp removal have growths that can't easily be removed with advanced endoscopic techniques, explains Dr. Buscaglia. "These findings suggest that we may need to tailor our surgical approach to ensure every patient receives the best care possible, regardless of polyp removal difficulty," he says.