Successful application of laparoscopic techniques in colorectal surgery and its indications

Patrick T. Delaplain, Mehraneh D. Jafari


Laparoscopic surgery is now widely used for a variety of indications, including both benign and malignant disease in colorectal surgery. There has been an increase in utilization of laparoscopy to treat colorectal pathology over the past decade. This adoption is likely related to the increased comfort among surgeons for laparoscopic surgery, and a growing body of literature that shows equivalent, if not superior, outcomes to open surgery. Many of the same safe practices that are used in open surgery can be applied laparoscopically as well. However, new issues and opportunities for improvement have come along with minimally invasive techniques. While abdominal entry was initially solely based on the location of the surgical target organ, we are now faced with choices regarding the initial entry into the abdomen and creation of pneumoperitoneum. It has also opened the door for early recovery protocols as a large incision is no longer a major determinant of hospital stay. We are also faced with an ever-growing list of indications and novel applications. As surgeons become more facile and instruments become more advanced, approaching emergent indications laparoscopically and avoiding open surgery should become standard of care. However, all of this progress relies on safe techniques, technical expertise and appropriate patient selection.