Laparoscopic colorectal surgery: new paradigm towards excellence

Abstract

There is evidence accumulated that the laparoscopic approach is equivalent or superior to an open operation for a broad spectrum of colorectal procedures. Laparoscopic colectomy has been accepted late due to its technical complexity and favorable outcome. This is because of its steep learning curve, concerns with oncological outcomes, lack of randomized controlled trials (RCTs) and initial reports on port-site recurrence after curative resection. As the field continues to evolve surgeons are gaining increasing experience with more complex procedures, including total abdominal colectomies and low pelvic dissection. These advances expand the spectrum of indications that are appropriate for laparoscopic approach and the number of patients who potentially benefit from the technique.