Laparoscopic techniques in intestinal surgery.
Laparoscopic bowel surgery has developed slowly over the last decade, with virtually all procedures having been attempted with these laparoscopic techniques. The benefits of this approach to colorectal surgery have resulted in decreased lengths of stay, smaller incisions, and a potentially lower risk of small bowel obstruction. Resection of benign inflammatory disease presents particular challenges and may be expected to result in higher conversion rates. However, with increasing experience, even complicated diverticular disease and Crohn's disease can be managed laparoscopically. There is a growing body of data that suggests the early concerns regarding colon cancer resection, specifically port site recurrences, may have been exaggerated. Even more importantly, the early results of a number of prospective randomized trials are suggesting that survival and cure rates are not jeopardized by laparoscopic colectomy. The surgical techniques are demanding and require a level of standardization to achieve success. Laparoscopic colorectal surgery will have a definite role in the future.
Senagore
A J
AJ
Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA. Senagoa@CCF.org
D015179:Colorectal Neoplasms / Q000601:surgery; D004238:Diverticulitis / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D012005:Rectal Prolapse / Q000601:surgery