Hybrid laparo-endoscopic approaches offer a safe alternative for resecting challenging colorectal lesions that standard endoscopy can’t handle.

• Only 5% of patients required additional surgery after hybrid resection (95% CI 3-8%).
• The incidence of unexpected adenocarcinoma was 12%, highlighting the need for careful patient selection.

These techniques can minimize patient morbidity while maintaining low complication rates, making them valuable for complex cases.

• Further multicenter studies are essential to enhance patient selection and assess long-term outcomes.