Laparoscopic colorectal surgery

Abstract

The introduction of laparoscopic techniques might be the most important development of recent decades in surgery. It has changed the face of surgery, and many procedures that used to require a laparotomy are now routinely performed with a minimally invasive approach. The laparoscopic approach is the gold standard in cholecystectomy, live kidney donation, fundoplication, Heller's myotomy, splenectomy, adrenalectomy, diagnostic laparoscopy combined with appendectomy, and rectopexy. In contrast to many of these laparoscopic techniques, the (broad) implementation of laparoscopic colorectal surgery has been slow and troublesome. Many surgeons embarked on laparoscopic colorectal surgery with great enthusiasm, but stopped because of operative time constraints, waiting lists, lack of evidence of the benefits of laparoscopic colorectal surgery, a competitive enhanced recovery after surgery programme (fast track, FT), increased procedural costs and above all, the long learning curve. Most of these issues reflect a lack of adequate training. © 2010 Springer-Verlag Berlin Heidelberg.