Laparoscopic Monitored Colonoscopic Polypectomy (LMCP)

Colonic polyps represent a common condition that requires their excision as they can become malignant lesions in a significant number of cases. While most of these polyps are resected by colonoscopy, some are very difficult to be approached endoscopically for a variety of reasons. Although most of these polyps are benign in nature, they traditionally have required a formal colon resection. We designed a very innovative, dual approach: we laparoscopically monitored the colonoscopic resection of these lesions, so we can be aware if any complication occurs. We analyze all polyps resected intraoperatively (frozen biopsy) and if any malignancy is suspected, we then proceed with a formal laparoscopic colon resection at the same setting.

Laparoscopic Treatment of Diverticular Disease

Diverticular disease is a very common disease, especially in the Western Hemisphere. When the presentation is acute, it normally requires a segmental colon resection and a temporary colostomy. We use a different approach to this problem, performing a diagnostic laparoscopy during the acute episode, that allows us to drain and lavage the abdominal cavity if needed, without any colostomy formation, and after a few months, we perform a laparoscopic colon resection of the affected part of the colon. The postoperative pain is significantly reduced, the recovery after surgery is quicker, and so is the return to normal activities.

Laparoscopic treatment of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a medical condition that sometimes requires a surgical intervention, normally secondary to complications. By means of minimally invasive techniques we decrease the insult to the body and to the immune system, besides all advantages common to laparoscopic colon procedures.

Laparoscopic treatment of Colorectal Cancer

Laparoscopic surgery is widely accepted for the treatment of benign colon diseases, but there is still some controversy regarding its use for the treatment of malignancies. We have been employing laparoscopic techniques for the treatment of colorectal cancer since 1991 under the frame of an ongoing, prospective study comparing laparoscopic versus open ("traditional") techniques for colorectal cancer. The results of our study, as other prospective, randomized studies currently going on worldwide show at least equal results in terms of survival and disease-free interval, and needs to be rewarded. We currently offer the laparoscopic approach to all our cancer patients, and most of our procedures are completed totally laparoscopically.

Treatment of Recurrent and Metastatic Colorectal Cancer

We also treat the recurrence of carcinoma laparoscopically whenever possible. One of the common manifestations of metastatic colon cancer is liver metastasis, and too often they present as multiple deposits and are difficult to treat by means of a liver resection. Chemotherapy is then the best choice. Our Institution is one of the few in the world that offers a laparoscopic placement of a hepatic artery catheter to deliver chemotherapy directly to the liver. This technique significantly decreases the morbidity associated with the placement of this device (avoiding laparotomy) and at the same time allows direct targeting of the hepatic metastatic tumor, minimizing the side effects of chemotherapy.