Polyps in the right colon which are difficult to remove by colonoscopy are routinely referred for segmental surgical resection, either by laparoscopic or open methods. Since most patients who form polyps are elderly, bowel resection may pose certain major risks and a hospital stay of several days. Eliminating the need for bowel resection but completely and definitively removing these polyps could make treatment safer. Although there are reports in the past of using a combined approach of colonscopy and laparoscopy to successfully remove large or technically difficult-to-remove polyps, this approach has been hampered by the distension of both small and large bowel during air insufflation needed during colonoscopy. This video outlines the key steps, using a case illustration in a 72 year old male, whereby simultaneous colonoscopy and laparoscopy are used to successfully remove two polyps from the right colon. The unique aspect of the technique is carbon dioxide (CO2) is used as the insufflating gas through the colonoscope, simultaneous with the CO2 used during laparoscopy. Since CO2 is absorbed through the colon wall 250 times faster than room air. There was no significant bowel distension during the operation. This permitted safe and thorough removal of the polyps using the colonoscopic approach, aided by invagination of the colonic wall using Laparoscopic tools. Finally, since the polyps removed may have resulted in a full thickness burn to the colon wall, laparoscopic suturing was used to oversew the wall at the polypectomy sites to increase the safety of the procedure. The patient was discharged in less than 24 hours following the procedure. Polyps were benign (tubulovillous adenomas). He recovered rapidly and without complications. In summary, this method, using a combined colonoscopic and laparoscopic approach in polyp removal, appears to overcome the problem of bowel distension by using CO2 insufflation via both the colonoscope and the laparoscope. It permits a long working time for colonoscopy and laparoscopy together to remove difficult polyps from the right colon, and may avoid the need for bowel resection in patients with polyps which cannot be removed solely by colonoscopy.