Lipomas are benign tumors that occur in soft tissues. About 1 out of every 100 people will develop a lipoma, meaning you have about a one percent chance of getting one of the benign tumors. For most, they don’t pose any type of harm. Colonic lipomas are those that occur in the gastrointestinal tract. Most cause no issues, and are only found incidentally during routine procedures.

How Is A Lipoma Diagnosed?

In most cases, a lipoma in the colon is found during a colonoscopy. During this test, it is usually possible to diagnose the tumor definitively based on its appearance and certain tests that rule out cancer and other dangerous growths. In other cases, contrast imaging may be needed to ensure the tumor is a lipoma. In these images, the growth should appear circular and smooth with clean edges. Occasionally, neither of these imaging tests can definitively rule out malignant growths, and the lipoma can only be accurately diagnosed after removal. This may lead to a more intensive surgery than might otherwise be necessary to remove a benign growth.  This is an extremely rare situation.

Is A Lipoma Causing My Symptoms?

Benign tumors in the colon can cause bleeding from the rectum, abdominal pain, constipation and a condition known as intussusception, when a section of the colon telescopes into itself creating a fold. Only rarely, if at all, does a colonic lipoma cause symptoms.  The most common symptoms of a lipoma in the colon are the most minor: abdominal pain and rectal bleeding.

Typically, doctors find that lipomas that cause symptoms are larger than typical, often more than 2 cm. If the growth is not treated, it may lead to anemia, nausea, weight loss and more severe gastrointestinal issues.

If only minor symptoms are present and a definitive diagnosis of a colonic lipoma can be made, your doctor may not recommend surgery. If you are experiencing ongoing or severe symptoms, however, you should discuss your treatment options with your doctor.

How Are Lipomas Treated?

In the past, problematic lipomas were treated with an invasive operation to remove the growth, often removing a section of the colon. Thankfully, today’s medical technology makes this type of surgery rare. While open surgery is occasionally called for, even large growths can usually be removed laparoscopically during what is sometimes called a keyhole surgery. Some can even be removed during an endoscopic procedure such as a colonoscopy. Because some therapeutic options may lead to more complications than the tumor itself, it is important to work with an experienced doctor when deciding which treatment best fits your needs.

Is Endoscopic Removal Possible?

Previously, only small and non-symptomatic lipomas were removed endoscopically during a colonoscopy. Today, more tumors are being removed in this minimally invasive way. While larger tumors often still require surgery, tumors smaller than 2 cm can usually be removed during these procedures and the diagnosis can be confirmed through lab testing.

The reason larger tumors cannot always be removed endoscopically is because of the risk of weakening the colon wall, leading to perforation. This is especially true if the base is broad.  Some doctors may inject the tumor’s base with a saline solution or medications to help prevent complications before endoscopic removal.

Ultimately, deciding if your lipoma can be removed endoscopically will be left up to your doctor. Some specialists are more comfortable removing larger tumors this way, and others prefer more invasive treatments because they can have fewer complications.

What Type Of Surgery Is Used To Remove A Lipoma?

Laparoscopic surgery is the most commonly used treatment for larger lipomas or those that cannot be definitely ruled out as cancerous lesions. Small, broad-based tumors may also be removed this way in order to protect the colon wall from hemorrhage or perforation. This surgery requires several small holes be cut in the abdomen to access the colon with special tools.

Laparoscopic lipoma removal is preferred over a traditional open surgery for a number of reasons. It requires only small incisions and the recovery period lasts only a few weeks. Patients spend less time in the hospital, and have less pain. Their bowels also typically return to normal faster. These factors make this the best approach for removal of tumors that cannot be removed endoscopically.

Whether it is performed laparoscopically or in an open surgery, removal of a lipoma from the gastrointestinal tract typically involves either making an incision in the colon, removing the lipoma and closing the incision or completely removing a small section, known as a segmental resection of the colon. Your doctor will determine which is best based on your individual situation. The decision should take into account the size of the growth, where it is located, whether there is a definitive diagnosis of a benign tumor, and any other complicating factors.

How Should I Determine What Is Best For Me?

The best way to weigh your options for colonic lipoma removal is to talk to your doctor about the pros and cons of each treatment based on your individual situation.  It is important to remember, though, that your doctor is there to help you make the best decision for your own health and well-being. Chances are, today’s technology will allow you to recover faster after endoscopic or laparoscopic removal of the tumor. In rare cases, however, more invasive surgery may be necessary.  But remember, the need for surgery for colonic lipomas is exceedingly rare.