Large Pedunculated Lipoma of the Colon: Endoscopic Resection Using “Loop-and-Let-Go” Technique

copy was performed showing a large, yellowish, and pedunculated subepithelial lesion with 30 mm of head diameter and 45 mm of stalk length, located at the sigmoid colon (Fig. 1a–c). Considering the lesion benignity in a symptomatic patient, it was decided to perform the polyp resection using a minimally invasive technique – “loopand-let-go.” A 30-mm endoloop® (Olympus, Tokyo, Japan) was maneuvered to capture the lipoma’s head and then carefully placed at the stalk base. A visible reduction in lesion vascularization was verified following sheathcontrolled closure (Fig. 1d–g). A formalin-filled container was given to the patient in case of polyp recovery. The patient recovered the colonic polyp within 4 days of endoscopic ligation and it was sent for histological characterization (Fig. 2a, b). Specimen histopathology showed a 30-mm adipose tissue on the submucosal layer, in relation to a fully-resected submucosal lipoma (Fig. 3a–c). The patient became asymptomatic with an uneventful course. Follow-up colonoscopy at 2 months was normal. Gastrointestinal lipomas are rare subepithelial benign tumors, being more common in the colon [1–4]. Diagnosis is usually easy because of typical endoscopic features.