Combined Endoscopic and Laparoscopic Surgery (CELS) for Colon Polyp Removal

CELS to the Rescue: How Combined Surgery Can Help with Difficult Colon Polyps

Lena Voss in Health & Wellness December 2025 • 4 min read.

"Discover the innovative approach of combined endoscopic and laparoscopic surgery (CELS) for removing challenging colon polyps, offering a safer alternative to traditional resections."

Colon polyps, those small clumps of cells that form on the lining of the colon, are often discovered during routine screenings. While most are harmless, some can develop into cancer if left untreated. Removing these polyps is a crucial step in preventing colorectal cancer, but what happens when a polyp is too large or located in a difficult-to-reach spot?

Traditionally, complex colon polyps that couldn't be removed with standard colonoscopy techniques required a more invasive procedure: a segmental colectomy, or surgical resection of a portion of the colon. While laparoscopic techniques have improved outcomes, any bowel resection carries significant risks and a potentially long recovery period.

Enter combined endoscopic and laparoscopic surgery, or CELS. This innovative approach combines the best of both worlds, using colonoscopy and laparoscopy to remove challenging polyps with greater precision and potentially fewer complications. This article will explore how CELS works, who might benefit from it, and why it's changing the landscape of colon polyp treatment.

What is Combined Endoscopic and Laparoscopic Surgery (CELS)?

Combined Endoscopic and Laparoscopic Surgery (CELS) for Colon Polyp Removal

CELS is a minimally invasive surgical technique that combines colonoscopy with laparoscopy to remove large or difficult-to-access colon polyps. The procedure begins with a standard colonoscopy to locate and assess the polyp. Next, small incisions are made in the abdomen through which a laparoscope (a thin, flexible tube with a camera) and other surgical instruments are inserted.

The laparoscope allows the surgeon to visualize the outside of the colon while the colonoscope provides a view from the inside. This dual perspective enables the surgeon to manipulate the colon, making it easier to remove the polyp endoscopically. In some cases, the laparoscopic instruments can also be used to assist in the polyp removal or to repair any potential damage to the colon wall.

Here’s a breakdown of the key benefits of CELS:

Minimally Invasive: Smaller incisions mean less pain, scarring, and a faster recovery compared to traditional open surgery.
Precise Polyp Removal: The combined view allows for more accurate and complete removal of the polyp.
Reduced Risk of Complications: Laparoscopic visualization helps prevent accidental damage to the colon wall, and any injuries can be repaired immediately.
Avoidance of Bowel Resection: CELS can often remove polyps that would otherwise require a more extensive surgery.

CELS isn't a one-size-fits-all solution. The decision to use CELS depends on several factors, including the size, location, and characteristics of the polyp, as well as the patient's overall health. A thorough evaluation by a gastroenterologist and a surgeon is essential to determine if CELS is the right approach.

The Future of Colon Polyp Treatment

Combined endoscopic and laparoscopic surgery represents a significant advancement in the treatment of challenging colon polyps. By combining the strengths of colonoscopy and laparoscopy, CELS offers a less invasive and potentially more effective way to remove polyps, reducing the need for major bowel resections and improving patient outcomes. As technology advances and more surgeons become proficient in CELS, this technique is likely to become an increasingly important tool in the fight against colorectal cancer.

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Everything You Need To Know

What is Combined Endoscopic and Laparoscopic Surgery (CELS), and how does it work?

Combined Endoscopic and Laparoscopic Surgery (CELS) is a minimally invasive surgical technique that combines colonoscopy and laparoscopy. First, a standard colonoscopy is used to locate and assess the colon polyp. Then, small incisions are made in the abdomen, and a laparoscope and other surgical instruments are inserted. The laparoscope provides a view of the outside of the colon, while the colonoscope provides a view from the inside. This dual perspective allows the surgeon to manipulate the colon and remove the polyp endoscopically, and in some cases, the laparoscopic instruments can also assist in the polyp removal or repair any potential damage to the colon wall.

What are the advantages of CELS over traditional methods for removing colon polyps?

CELS offers several key advantages over traditional methods, such as segmental colectomy. CELS is minimally invasive, which means smaller incisions, less pain, scarring, and faster recovery compared to traditional open surgery. The combined view from colonoscopy and laparoscopy allows for more accurate and complete polyp removal. It also reduces the risk of complications because laparoscopic visualization helps prevent accidental damage to the colon wall, and any injuries can be repaired immediately. CELS can often remove polyps that would otherwise require a more extensive surgery, avoiding the need for bowel resection.

Who is a good candidate for Combined Endoscopic and Laparoscopic Surgery (CELS)?

The decision to use CELS depends on several factors. These include the size, location, and characteristics of the polyp, as well as the patient's overall health. CELS is not a one-size-fits-all solution, therefore a thorough evaluation by a gastroenterologist and a surgeon is essential to determine if CELS is the right approach. Generally, CELS is considered for large or difficult-to-access colon polyps that cannot be removed with standard colonoscopy techniques.

How does CELS help in preventing colorectal cancer?

Removing colon polyps is a crucial step in preventing colorectal cancer because some polyps can develop into cancer if left untreated. CELS facilitates the removal of these potentially cancerous polyps, especially those that are large or in difficult locations. By using colonoscopy and laparoscopy together, CELS ensures more complete and precise polyp removal, reducing the risk of cancer development and the need for more invasive surgeries like bowel resection.

What does the future hold for Combined Endoscopic and Laparoscopic Surgery (CELS) in the treatment of colon polyps?

CELS represents a significant advancement in the treatment of challenging colon polyps. As technology advances and more surgeons become proficient in CELS, this technique is likely to become an increasingly important tool in the fight against colorectal cancer. It offers a less invasive and potentially more effective way to remove polyps, reducing the need for major bowel resections and improving patient outcomes. The ongoing development and wider adoption of CELS promise to enhance the precision and effectiveness of colon polyp treatment further.