title: Endoscopic tattooing to aid tumour localisation in colon cancer: the need for standardisation.
abstract: OBJECTIVE
  An increasing number of colon and rectal tumours are being resected using laparoscopic techniques. Identifying these tumours intraoperatively can be difficult. The use of tattooing can facilitate an easier resection; however, the lack of standardised guidelines can potentially lead to errors intraoperatively and potentially result in worse outcomes for patients. The aim of this study was to identify the most reliable method of preoperative tumour localisation from the available literature to date.
  
  
  METHODS
  A literature review was undertaken to identify any articles related to endoscopic tattooing and tumour localisation during colorectal surgery.
  
  
  RESULTS
  To date there is still mixed evidence regarding tattooing techniques and the choice of ink that should be used. There are numerous studies demonstrating safe tattooing techniques and highlighting the risks and benefits of different types of ink available.
  
  
  CONCLUSIONS
  Based on the available studies we have recommended a standardised approach to endoscopic tattooing of colorectal tumours prior to laparoscopic resection.
authors.affiliation: Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland. reynoli@tcd.ie.
authors.forename: I S
authors.initials: IS
authors.lastname: Reynolds
authors.affiliation: Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: M H
authors.initials: MH
authors.lastname: Majeed
authors.affiliation: Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: I
authors.initials: I
authors.lastname: Soric
authors.affiliation: Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Whelan
authors.affiliation: Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Deasy
authors.affiliation: Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland. reynoli@tcd.ie.
authors.forename: D A
authors.initials: DA
authors.lastname: McNamara
mesh_terms: D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013653:Tattooing / Q000592:standards*
keywords: Colorectal cancer; Endoscopic tattooing; Laparoscopic surgery; Spot dye; Tumour localisation: India ink