Laparoscopic colorectal surgery in progress.

Nearly all standard colorectal operations have been attempted by the laparoscopic method. While bowel surgery is substantially more difficult it is proven feasible for most operations but its spread is slow. Less than 5% of all abdominal colorectal surgery is done laparoscopically a proportion which may rise to 20% in departments with a special interest. The complexity of the operation demands the learning of new skills which it will not be possible for all currently active colorectal surgeons to acquire. The learning phase is substantial, especially for resections, and yet the operation time remains about an hour longer than that of the open operation. Laparoscopic colorectal surgery is a fascinating subject because of its technical content, rapid change, and vitalisation of surgical thinking with profound repercussions on traditional operative technique. After seven years of breaking new ground it is time for the laparoscopic colorectal surgery to progress from a demonstration of what is possible to demonstrate when laparoscopy produces consistently better results at acceptable cost.