Laparoscopic colorectal surgery

Abstract

Laparoscopy was first described at the beginning of 20th century. The interface of creative surgeons and novel technology has resulted in significant advances and has radically transformed the landscape of operative surgery. In almost a century of gastrointestinal surgery, few advances can compare to the revolution engendered by the advent of minimally invasive surgery. Minimally invasive surgery has become the standard of care for a number of gastrointestinal afflictions. Refinement of laparoscopic techniques has been the biggest contributor to the increase in the number of procedures performed in the last decade. The associated shorter length of stay, quicker recovery, less pain and large reduction in wound related problems has led to an increase in patient demand. Physiological basis for the benefits ascribed to minimally invasive surgery resides in the theoretic reduction in the inflammatory and immune responses when compared with conventional open approach. Pain caused by laparoscopic surgery is variable in duration, intensity and character. A combination of simple measures such as evacuating the insufflated gas, use of local anesthetic, preoperative use of paracetamol and use of moderately short acting intraoperative opioid reduces the immediate and referred pain. As in all aspects of medicine, Laparoscopic surgery requires experience on the part of surgeon in order to afford patients the best possible outcome and deal with the unique complications associated with its approach. In general laparoscopic approach should be considered for operations if same or similar procedure can be performed as would be done with open surgery with more benefits and less complications.