title: Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations.
abstract: The introduction of laparoscopy is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of controlled studies and meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits than other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. On the other hand, despite initial concerns about oncological safety, well-designed prospective randomized multicentre trials have demonstrated that oncological outcomes of laparoscopy and open surgery are similar. Although the use of laparoscopy in colorectal surgery has increased in recent years, the percentages of patients treated with surgery using minimally invasive techniques are still reduced and there are also substantial differences among centres. It has been argued that the limiting factor for the use of laparoscopic procedures is the number of surgeons with adequate skills to perform a laparoscopic colectomy rather than the tumour of patients' characteristics. In this regard, future efforts to increase the use of laparoscopic techniques in colorectal surgery will necessarily require more efforts in teaching surgeons. We here present a review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intra-corporeal anastomosis after right hemicolectomy. We also describe the results of latest innovations such as single incision laparoscopic surgery, robotic surgery and natural orifice transluminal endoscopic surgery for colon and rectal diseases.
authors.affiliation: Marta Pascual, Silvia Salvans, Miguel Pera, Section of Colon and Rectal Surgery, Department of Surgery, Hospital del Mar, Medical Research Institute, 08003 Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Pascual
authors.affiliation: Marta Pascual, Silvia Salvans, Miguel Pera, Section of Colon and Rectal Surgery, Department of Surgery, Hospital del Mar, Medical Research Institute, 08003 Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Salvans
authors.affiliation: Marta Pascual, Silvia Salvans, Miguel Pera, Section of Colon and Rectal Surgery, Department of Surgery, Hospital del Mar, Medical Research Institute, 08003 Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Pera
mesh_terms: D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000601:surgery*; D004059:Diffusion of Innovation; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome
keywords: Colorectal cancer; Inflammatory bowel disease; Laparoscopy; Natural orifice transluminal endoscopic surgery; Robotic surgery; Single incision laparoscopic surgery; Surgical innovations
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