New combined laparoscopy and colonoscopy procedure at NYPH/Weill Cornell

Mar 4 2007

A small number of patients diagnosed with polyps in their large intestine have extensive or difficult-to-remove polyps, such as those that are flattened against the colon wall or in hard-to-reach places. As with all polyps that may develop into malignant cancers, they must be removed.

Unlike regular polyps, extensive or difficult-to-reach polyps have, until now, necessitated open surgery with a lengthy recovery time. Now, an experimental procedure, laparoscopic surgery combined with carbon-dioxide assisted colonoscopy, allows most patients to return home in less than a day -- a potential advantage over traditional open surgery, which requires a three-to-seven-day hospital stay. The new procedure was developed and offered exclusively in the New York area by colon and rectal surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

"It's reassuring to our patients getting preventive colonoscopies that no matter what kind of polyp we find, in almost all instances, we can remove it with minimal discomfort and inconvenience," says Dr. Jeffrey Milsom, the DeCosse Distinguished Professor of Surgery at Weill Medical College of Cornell University and attending surgeon at NewYork-Presbyterian/Weill Cornell.

The new procedure, which was developed by Dr. Milsom and colleagues at NewYork-Presbyterian/Weill Cornell, is a combination of traditional colonoscopy and laparoscopic surgery, in which surgeons inflate the colon with CO2, locate the polyp via colonoscopy, then use new laparoscopic techniques to facilitate the endoscopic removal of the lesion. The procedure can be augmented and made safer with a few quick sutures placed laparoscopically where the polyp once was.

"Unlike regular air that is used in traditional colonoscopic procedures, carbon dioxide doesn't cause the patient to get bloated or make the bowels distended. It also quickly deflates, giving us room to remove the polyp," says Dr. Milsom.

A study published in the March 2005 journal Surgical Endoscopy and authored by Dr. Milsom found the procedure to be feasible, safe and of practical value for minimizing bowel distention. Further research, including tools to make the procedure even better, is ongoing.

NewYork-Presbyterian/Weill Cornell is one of only a few centers nationally to offer laparoscopic colorectal surgery on a routine basis. Nearly 80 percent of colorectal surgeries are performed laparoscopically. Conditions treated include cancer, inflammatory bowel disease (IBD), Crohn's disease and diverticulitis.