Use of laparoscopic techniques in colorectal surgery. Preliminary study.
OBJECTIVE
This study evaluated the feasibility and safety of laparoscopic bowel surgery performed by colorectal surgeons not previously experienced in laparoscopic biliary or appendiceal surgery.


METHODS
Thirty-two patients underwent ileocolic resection/anastomosis (n = 12), loop ileostomy (n = 7), colostomy (n = 4), ileostomy takedown/ileorectal anastomosis (n = 3), subtotal colectomy/ileorectal anastomosis (n = 2), sigmoid resection (n = 2), or other procedures (n = 2). No curative cancer surgery was undertaken.


RESULTS
Time to first bowel movement was one to eight (median, four) days. Length of stay ranged from 4 to 11 (median, 6) days. There were no major complications seen in follow-up from 6 to 15 (median, 7) months after surgery.


CONCLUSIONS
Large intestinal and distal ileal surgery using laparoscopic techniques, performed by surgeons with training only in laparoscopic intestinal surgery, is feasible and safe. Faster recovery and need for less postoperative analgesia in laparoscopic surgery compared with conventional surgery cannot be surmised from this study. A randomized study design is needed to evaluate many of the differences between conventional and laparoscopic intestinal surgery.
Milsom
J W
JW
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44195-5044.
Lavery
I C
IC
Church
J M
JM
Stolfi
V M
VM
Fazio
V W
VW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003106:Colon / Q000502:physiology / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D003125:Colostomy; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000502:physiology / Q000601:surgery*; D007410:Intestinal Diseases / Q000503:physiopathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000502:physiology / Q000601:surgery*; D013997:Time Factors