Endoscopic resection of large symptomatic colonic lipo-mas is a challenge even for experienced endoscopists because it is technically difficult and carries an increased risk of bleeding or perforation. To create conditions for safe endoscopic removal of large lipomas, several techniques have been used, including endosonographic guidance, submucosal injection of saline or epinephrine, and endoloop-assisted snare resection. Moreover, Raju and Gomez recently used repeated endo-loop ligation of a large pedunculated colonic lipoma, achieving complete resorption of the lipoma in a period of 8 months.
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