Laparoscopic management of iatrogenic colonoscopic perforation - a video vignette.

: Iatrogenic colonoscopic perforation is a rare but serious complication during colonoscopy. The recent guidelines suggest a perforation rate following complex polypectomy of 1% or less The management options for patients with colonoscopic perforation include conservative management (haemodynamically stable, no sepsis, localized pain, no free fluid on CT), endoscopic closure (with in 4 hours, small size, cause of perforation and experience of endoscopist) or emergency surgery (peritonitis, clinical deterioration, suspected large perforation, poor bowel preparation, underlying colonic disease).1 Those patients needing surgery can be explored laparoscopically depending upon the surgical expertise and patient's suitability for laparoscopy. The laparoscopic technique has been shown to have lower morbidity and mortality compared with the open technique in penetrating colonic injuries. Similarly, laparoscopic surgery has been shown to have less post- operative complications, shorter hospital stay and less stoma rate in retrospective case series.