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Laparoscopic Surgery is used for conditions of the colon and rectum in the
same way as is in other conditions of the abdomen. The technique consists of
performing the surgery not through the traditional midline abdominal incision
but through 5 “keyholes”. Through the “keyholes” a camera and special
instruments are introduced. Most of the operation is performed through the
keyholes and the resected part of the bowel is retrieved through a small
incision.
Advantages of Laparoscopic Colorectal Surgery
- Less pain
- Fewer wound infections
- Fewer post-operative hernias
- Fewer respiratory complications
- Faster return of bowel function
- Faster hospital recovery
- Shorter hospital stay
- Faster return to work – normal activities
- Better cosmetic result
Laparoscopic colorectal surgery is applied for almost all bowel pathologies that
need surgery. The technique has emerged in the 1990s but it has really
started becoming popular with colorectal surgeons only after 2000. There
were some initial doubts as to whether it is safe to perform in colorectal
cancer. Those doubts have now disappeared because there has been a
number of large studies in the USA, UK and Europe which prove that
Laparoscopic Colorectal Surgery is perfectly safe for cancer, provided of
course that the surgeon who attempts it is skilful and appropriately trained.
More specifically, Total Mesorectal Excision, TME, the technique which is
crucial for treatment of rectal cancer can be performed laparoscopically.
Laparoscopic Colorectal Operations
- Laparoscopic Right Hemicolectomy
- Laparoscopic Left or Sigmoid Colectomy
- Laparoscopic Anterior Resection of the Rectum
- Laparoscopic Abdomino-perineal Resection of the Rectum
- Laparoscopic Total Colectomy
- Laparoscopic Reversal of Colostomy
- Laparoscopic Restorative Proctocolectomy
- Laparoscopic Small Bowel Resection
- Laparoscopic Adhesioslysis
- Laparoscopic Appendicectomy
TEMS (Transanal Endoscopic Micro-Surgery) is a particular form of
endosocpic-laparoscopic operation for rectal tumours which is described in
details elsewhere.
Requirements and contra-indications
Laparoscopic Colorectal Surgery is challenging and the surgeon attempting it
must be skilful in laparoscopy and adequately trained. Patients who have
multiple previous abdominal operations may not be suitable for laparoscopic
surgery, as well as patients who are excessively overweight.
RECENT NICE GUIDELINES
In 2006 the National Institute of Clinical Excellence issued guidelines which
confirm that laparosocpic colorectal surgery is appropriate and beneficial
treatment for colorectal cancer, provided that it is undertaken by trained
laparoscopic surgeons.
You can read the full NICE guidelines on laparoscopic surgery for
colorectal cancer by clicking here.
You can read the NICE information for patients on laparoscopic colorectal
surgery by clicking here.
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Laparoscopic Colorectal Surgery