A recent major advance in the surgical treatment of
colorectal cancer has been the introduction of laparoscopic surgery. Laparoscopic
colectomy is associated with decreased
postoperative pain, faster
ileus resolution, shorter
hospital stay, improved cosmesis, and decreased morbidity when compared with open
colectomy. However, early reports of high rates of laparoscopic
wound metastases gave rise to questions regarding the adequacy of the laparoscopic technique for curative resection of
malignancies. These concerns over oncologic outcomes are addressed by several single and multi-institutional randomized trials in the United States and throughout the world that have compared laparoscopic-assisted
colectomy with conventional open
colectomy. These studies have established both the short- and long-term safety and oncologic efficacy of laparoscopic
colectomy for
cancer. To ensure successful outcomes, surgeons performing laparoscopic
colectomy should be adequately experienced. Limitations include the technical requirements of advanced laparoscopic skills and training, increased
operative time, and equipment costs. Despite these limitations, patient recovery benefits may offset the increased operative costs and result in improved outcome overall.