ABSTRACT
Laparoscopy has emerged as a useful tool in the surgical treatment of diseases of
the colon and rectum. Specifically, in the application of colon cancer, a laparoscopic-assisted
approach offers short-term benefits to patients while maintaining a long-term oncologic
outcome. Hand-assisted laparoscopic surgery may help decrease operative times while
preserving the benefits of laparoscopy. The literature on the use of laparoscopy for
rectal cancer is still in its early stages. Limited data suggest short-term benefits
without compromising oncologic outcome; however, data from large multicenter trials
will clarify the role of laparoscopy in the treatment of rectal cancer. Robotic proctectomy
is a novel technique that may offer considerable advantage and overcome some limitations
laparoscopy creates while working in the confines of the pelvis. The improved magnification
and visualization offered with the robot may also assist in preserving bladder and
sexual function. Transanal endoscopic microsurgery (TEM) for the treatment of T1 rectal
cancers with low-risk features appears to be safe. However, TEM has a significantly
higher recurrence rate when used to treat invasive cancer. Endoluminal techniques
and equipment are under development and could offer more minimally invasive approaches
to the treatment of colon and rectal cancer. Credentialing and training of surgeons
and teams involved in the use of laparoscopy is important prior to making these techniques
ubiquitous.
KEYWORDS
Colon cancer - rectal cancer - laparoscopy
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Govind NandakumarM.D.
Section of Colon and Rectal Surgery, Washington University School of Medicine
660 South Euclid Ave, Box 8109, St. Louis MO 63110
Email: doctorgovind@gmail.com
