Colorectal surgery

Abstract

Despite the fact that the first laparoscopic colectomy was performed more than 10 years ago, this approach has not become the standard of care for benign or malignant colon disease in the United States. Even though a limited number of surgeons across the country have gained experience with the technique and have adopted its use into their practice, there remains resistance on the part of most general and colorectal surgeons to focus their efforts on learning the skills needed to safely and efficiently perform laparoscopic colon procedures. The technique is not readily assimilated as cholecystectomy or even Nissen fundoplication due to complexity, disease factors, operating times, anatomical variation, and limited technology. However, the ultimate role that laparoscopy will have in the treatment of diseases of the colon and rectum remains a matter of debate. The training of young surgeons and residents to perform complex laparoscopic procedures and a concerted effort by the Program Directors Association for Colorectal Surgery to emphasize laparoscopic training may overcome some of the barriers in the future.