Laparoscopic colectomy in diverticular and Crohn's disease.

Laparoscopy is still controversial when applied for the attempted cure of colorectal cancer. Although some advantages may be possible, some disadvantages also have been postulated. Laparoscopic treatment of benign disease is far less controversial. Three of the best procedures and indications, respectively, are laparoscopic sigmoid colectomy for diverticulitis, laparoscopic-assisted ileocolic resection for terminal ileal Crohn's disease, and laparoscopic stoma creation for perianal Crohn's disease. Other potentially advantageous surgeries and indications include laparoscopic-assisted total abdominal colectomy for colonic Crohn's disease, laparoscopic total proctocolectomy for colonic and anorectal Crohn's disease, and laparoscopic secondary ileoproctostomy or coloproctostomy as Hartmann reversal procedures. Significant benefits can be expected with these procedures relative to decreased pain; ileus; length of hospital stay; disability, and, possibly, adhesion formation and subsequent bowel obstruction, and improved cosmesis.