Laparoscopic colorectal surgery: why, when, how?

Excerpt

Since 1987 and the first laparoscopic cholecystectomy, laparoscopic surgery has spread tremendously in gastrointestinal surgery. Within a few years, there was widespread adoption of laparoscopy as the standard surgical approach in a growing number of pathologies. However, for colorectal surgery, the uptake of laparoscopy has been dramatically slower. One explanation is that laparoscopic colorectal resection is a technically complex procedure (colon and rectum mobilization, dissection in several abdominal quadrants, intracorporeal division of major vessels and ligation at their origins in case of malignancy, extraction of large specimens and performance of a bowel anastomosis), with a steep learning curve that requires a good surgical experience. However, the boundaries have been pushed back over the two last decades by growing experience of surgeons and technical advances, making laparoscopy the surgical approach of choice for colorectal resection in nearly all patients. …