VM80 - Robotic Colon Lipoma Excision via Colotomy with Natural Orifice Extraction

Purpose/Background: Colon Lipomas are rare benign intestinal tumors with incidence rate of 0.2% to 4.4%. They are usually small and asymptomatic, however up to 25% can cause clinical manifestations like abdominal pain, intestinal obstruction and bleeding. While there are no set guidelines for management of colon lipomas, they are usually excised endoscopically. When the lipoma is unsafe for endoscopic excision, surgery is the next option. Here we present a case of a patient who underwent robotic colon lipoma excision via colotomy with natural orifice specimen extraction.

Methods/Interventions: 57 year old male with incidental finding of 4 cm sigmoid colon lipoma on screening colonoscopy. We describe the preoperative work up leading to the surgery and show the video of the robotic excision of the colon lipoma via sigmoid colotomy. The lipoma was extracted transanally using colonoscopy.

Results/Outcomes: Patient had a successful excision of a sigmoid colon lipoma and the specimen was successfully removed via colonoscopy with no post operative complications. The patient did well post operatively and was subsequently discharged on postoperative day 1.

Conclusion/Discussion: Natural Orifice Specimen Extraction Surgery is a feasible option for benign colorectal diseases like large colon lipomas. This method can help avoid the trauma of creating a 'mini-laparotomy' incision on the abdominal wall for specimen extraction.