Navigation Links
New alternative to surgery lets doctors remove suspicious polyps, keep colon intact

Millions of people each year have polyps successfully removed during colonoscopies. But when a suspicious polyp is bigger than a marble or in a hard-to-reach location, patients are referred for surgery to remove a portion of their colon even if doctors aren't sure whether the polyp is cancerous or not.

Since only 15 percent of all polyps turn out to be malignant, many patients are unnecessarily subjected to the risks of this major surgery. Now there is an alternative.

A UCLA team of surgeons and gastroenterologists has been performing a new, minimally invasive procedure to remove large and hard-to-reach polyps while keeping the colon intact. The procedure, which combines two minimally invasive techniques, has currently been performed at only a handful of medical centers in the United States.

In the June issue of the journal Surgical Endoscopy, the UCLA researchers present their experiences using the new technique known as CELS, for combination endoscopy and laparoscopy surgery and offer the first comparison of the new technique and standard surgery.

"The CELS approach combines the best of minimally invasive techniques and may prove to be a viable option for select patients," said senior author Dr. James Yoo, an assistant professor of surgery and chief of the colon and rectal surgery program for the UCLA Health System and the David Geffen School of Medicine at UCLA.

For the study, the team compared outcomes for five patients who underwent the new procedure with outcomes for nine patients who received standard surgery to remove suspicious polyps between August 2008 and October 2012.

The new technique starts out like a colonoscopy, with a gastroenterologist advancing an endoscope inside the colon. The endoscope, a device with a small video camera and a light attached, lets doctors look inside the body cavity. Once a polyp is in sight and the gastroenterologist is ready to remove it, the surgeon uses minimally invasive surgical tools, inserted through two to four tiny incisions in the abdomen, to carefully maneuver and manipulate the colon, allowing the gastroenterologist better access to the polyp.

If the polyp is in a tricky location, such as a fold of the colon, the surgeon can gently undo the fold temporarily. If the polyp is large and deeply embedded, the surgeon can monitor the outside of the colon with a tiny camera and, if needed, perform minor wall repair to the colon after the polyp is removed.

Once the polyp is removed, it is immediately taken to the lab for analysis to determine if it's benign or cancerous, while the team and patient wait in the operating room. The analysis takes about 30 minutes. If the polyp turns out to be cancerous, the team proceeds with the standard surgery to remove the affected portion of the colon.

According to the UCLA report, all polyps were successfully removed with the new CELS procedure, and the complication rate was lower than with standard surgery. Four out of the five patients who had the CELS procedure, and six out of nine patients who received standard surgery, were found to have benign polyps.

The procedure time and hospital stay were shorter with the new procedure, the researchers found. Operating time averaged 159 minutes, compared with 205 minutes for standard surgery, and the median hospital stay was one night with the new procedure and five nights with standard surgery.

"The majority of patients in the study had a benign polyp," Yoo said. "We found that the new procedure can be performed safely with outcomes that compare favorably with standard surgery for these select patients."

In the majority of the CELS cases, findings from the quick lab analysis were accurate. However, one patient's final pathology report, which came back a week later, showed that the polyp was cancerous, so that patient was scheduled for standard surgery.

Yoo noted that in the future, newer imaging methods and lab analysis may make it easier to differentiate between a benign and malignant polyp.

"Although this is a small study with one institution's experience, newer technology is helping doctors raise the bar and offer more minimally invasive procedures with less down-time and trauma for the patient," said Dr. Eric Esrailian, co-chief of the division of digestive diseases for the UCLA Health System and the Geffen School of Medicine, who was part of the UCLA team.

Physicians note that patients who successfully undergo the CELS procedure still require follow-up endoscopic evaluation and that surgery is still the standard treatment for cancer or cancerous polyps or if the polyp cannot be removed endoscopically even with the CELS technique.

The next step in research, according to the UCLA team, is a multi-institutional study to further examine use of the CELS approach to better characterize its impact on surgery.


Contact: Rachel Champeau
University of California - Los Angeles Health Sciences

Related medicine news :

1. Genomic assay as an alternative to animal testing
2. Grand Prairie of Macomb Assisted Living to Host Alternatives for Older Adults Workshop on Sharing the Caring
3. Online USA Doctors Introduces a Convenient and Affordable Alternative to Office Visits with Primary Care Physicians
4. Online USA Doctors Launches New Telemedicine Based Healthcare Plans; an Affordable Alternative to Health Insurance
5. Best High-Speed Internet Service Alternatives to Cable in 2013 by
6. Offers the Number One Alternative for Sun Damage Prevention
7. Improve Eyesight Naturally Emerges As An Alternative To Corrective Eye Surgeries: User Gets 20/ 20 Vision In Three Months - Vision Without Glasses
8. New screening approach uncovers potential alternative drug therapies for neuroblastoma
9. hCGTreatments/Diet Doc hCG Diet & Weight Loss Plans Now Teach Patients How to Lose Weight Safely and Offer Alternative to Weight Loss Surgery Now Linked to Colon Cancer
10. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Offers Safe and Healthy New Fast Weight Loss Alternative for At-Risk Heart Disease Patients
11. During Celiac Awareness Month, Nutrition Expert Keri Glassman Encourages People with Celiac Disease to Find a Fiber Alternative like Konsyl Original Formula
Post Your Comments:
(Date:12/1/2015)... ... , ... With FCPX Overlay: Grit , users can apply a grit ... are truly endless, all with a click of a mouse. Each user has full ... depth of field and more, all within Final Cut Pro X. , With FCPX ...
(Date:12/1/2015)... ... December 01, 2015 , ... SonaCare ... 2015 HSJ Acute Sector Innovation Award on November 18th. This prestigious award recognizes ... and propose exciting enhancements to the medical landscape. , The UCLH team won ...
(Date:11/30/2015)... ... 30, 2015 , ... Olympic Gold Medalists and Celebrity Moms ... across various categories through traditional and social media marketing campaigns and other branding ... Gold Medal Moms who can connect with today’s most important consumer: mothers. In ...
(Date:11/30/2015)... NY (PRWEB) , ... December 01, 2015 , ... ... honors Christina Colon as a 2015-2016 inductee into its VIP Woman ... in pharmacy. NAPW is the nation’s leading networking organization exclusively for professional women, ...
(Date:11/30/2015)... Los Angeles, California (PRWEB) , ... November 30, ... ... in all the programs of the19th Bi-National Convention of the Federation of Philippine ... Resort and Casino in Las Vegas, Nevada. , 1Heart Caregiver Services, as ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... BASEL, Switzerland , Dec. 1, 2015  Roche ... wholly-owned UK subsidiary Proximagen Ltd., today announced a worldwide ... small molecule inhibitor of Vascular Adhesion Protein 1 (VAP-1), ... treatment of inflammatory disease. The VAP-1 inhibitor is currently ... --> Under the terms of the ...
(Date:11/30/2015)... LOUIS , Dec. 1, 2015 Express Scripts ... Imprimis Pharmaceuticals (NASDAQ: IMMY ) to drive access to ... for the treatment of toxoplasmosis that has been recently priced ... others with weakened immune systems. --> ... of pyrimethamine and leucovorin (a form of folic acid) for $1 ...
(Date:11/30/2015)... Die MEDTEC Japan 2016, ... Entwicklung und Herstellung medizinischer Geräte, findet ... in Tokyo ... Foto: ... --> ...
Breaking Medicine Technology: