Colonoscopic-assisted laparoscopic resection of a colon lipoma

We report the case of a 51-year-old man who had abdominal distension and intermittent cramping pain for 4 months. A lower gastrointestinal double-contrast study revealed a protruding mass at the transverse colon. Endoscopic ultrasonography showed a lesion arising from the submucosal layer. Instead of a laparotomy, the lesion was removed laparoscopically with the assistance of a colonoscope. No operative morbidity was noted. With future improvements of this technique, tumors that are difficult to remove with colonoscopy can be excised laparoscopically without the aid of an endoscopic stapler. In our case, the tumor was localized intraoperatively and extracted using the intraoperative colonoscopy. This double-scope technique is safe and cost-effective for some difficult colonic lesions.