Laparoscopic Colorectal Surgery: Indications and Techniques

Single‐incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis

“…[1] reported the first successful laparoscopic right hemicolectomy in 1990, yet the uptake of laparoscopic colorectal surgery (LCRS) has been slow [2]; 8.2% of UK resections are performed laparoscopically [3] and only 18% of Association of Coloproctology of Great Britain and Ireland (ACPGBI) members have a laparoscopic practice approaching 50% of suitable cases [2]. This poor uptake arose through initial concerns about oncological safety [4–6] and a technically demanding learning curve [7–9]. Large randomized trials (CLASICC [10], COST [11], Barcelona [12]), Cochrane reviews [13] and meta‐analyses [14] have all concluded that LCRS is not only safe, but it is also associated with better short‐term outcome and does not worsen long‐term cancer survival.…”

Laparoscopic colorectal surgery - why would you not want to have it and, more importantly, not be trained in it? A consecutive series of 500 elective resections with anastomoses

“…In the 12‐month period to March 2007, 8.82% of resections were performed by this method [4]. Explanations offered included concerns about oncological safety [5–7] and the recognition of the relatively long and technically demanding learning curve [8–11]. Large long‐term randomized control trials of laparoscopic surgery for colorectal cancer have supported the view that the original concerns were unfounded (MRC CLASICC [12], COST [13] and Barcelona [14] trials).…”

Competency in laparoscopic colorectal surgery is achievable with appropriate training but takes time: a comparison of 300 elective resections with anastomosis

“…In the 12‐month period upto March 2007, 8.82% of resections were performed by this method (Nice 2006) [6]. Major reasoning for this delayed uptake included early concerns about oncological safety [7–9] and the recognition of the relatively long and technically demanding learning curve [10–13]. Large, long‐term randomized control trials of laparoscopic surgery for colorectal cancer have supported the view that the original concerns were unfounded (MRC CLASSIC [14], COST [15] and Barcelona [16] trials).…”