Minimally invasive approach to colorectal surgery.
While the development of laparoscopic surgery over the last two decades was amazingly fast, its adoption was neither uniform nor universal. Some procedures, like laparoscopic cholecystectomy, rapidly became the standard of care throughout the surgical community. Laparoscopy for colorectal surgery gained much less acceptance. Factors such as technical complexity, cost, duration of surgery and concerns about oncologic safety influenced the hesitancy in performing this surgery, and it took the surgical community more than a decade to admit that the laparoscopic option is legitimate: it is safe, and it provides the patients with the advantages of minimally invasive surgery, without any surgical or oncologic compromise. This slow process of maturation had a significant advantage, as it allowed this kind of surgery to be thoroughly investigated. Its acceptance is now well based on multitude of data, available from many basic science and clinical studies. Not many procedures in the daily surgical practice are as evidence-based as is laparoscopic colon surgery. The aim of this review was to describe some general aspects of laparoscopic colorectal surgery, and examine the data supporting its use in different procedures for various pathologies, both benign and malignant.
Rosin
D
D
Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Israel. drosin@mac.com
Khaikin
M
M
Zmora
O
O
D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery; D003125:Colostomy / Q000379:methods; D004239:Diverticulitis, Colonic / Q000601:surgery; D019317:Evidence-Based Medicine; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D045822:Intestinal Volvulus / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011788:Quality of Life; D012002:Rectal Diseases / Q000601:surgery*; D012005:Rectal Prolapse / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome