Laparoscopic colon resection.

Laparoscopic colectomy, usually performed in a laparoscopy-assisted fashion, is a technically difficult operation not easily mastered by the average surgeon and requiring a skilled team for its successful completion. There is a significant learning curve for the procedure, and conversion to open colectomy has been necessary in about 25% of cases in collected series. As such, its popularity has increased only slowly, and currently it is appropriate for treatment of benign colonic disease and as a palliative approach for unresectable carcinoma. Although the procedure produces an adequate tissue resection, concern about trocar site tumor recurrences has led to the general consensus that the procedure should currently be done only in a prospective investigational protocol setting for the treatment of curable colorectal carcinoma. These studies are expected to yield the data critically needed to assess its role in treating this disease. Experience to date suggests that laparoscopic colectomy can be performed with morbidity and mortality lower than or comparable to those of open colectomy. It likely is associated with less postoperative pain and a shorter hospitalization and has the potential for modestly more rapid recovery of gastro-intestinal function than open colectomy.