Current Aspects of Laparoscopic Colorectal Surgery: Indications Methods Results

This publication of the papers presented at the Workshop on Laparoscopic Colorectal Surgery that took place on 27-29 November 1995 in the European Surgical Institute in Norderstedt, Germany, is effectively a snapshot of the current state of knowledge in both the theory and the practice of minimally invasive colon surgery. This snapshot is a mosaic made up of the varied ex­ periences of individual surgeons. After a long period in which nothing much seemed to be happening, the recent growth in the use of minimally invasive surgery or video-controlled operative procedures in surgery of the abdominal and chest cavities has been unparalleled. More difficult operations have become increasingly possible as more and more new techniques have become available. Cholecystectomy should be regarded as the pacesetter for video-controlled procedures. Under defined conditions, it has now become the standard operation. Other operative procedures such as appendicectomy, hernior­ rhaphy, overs ewing of a perforated gastric or duodenal ulcer, vagotomy and fundoplication, operations on the spleen or adrenal, staging operations., and thoracic surgical procedures are becoming increasingly widely performed. Minimally invasive operations on the small and large bowel are currently still at the stage of individual reports.

Laparoscopic video-assisted surgery has rapidly gained acceptance as a means of performing certain procedures on the gastrointestinal tract that were developed and standardized by the conventional, open approach. This is the case for cholecystectomy and, to a lesser degree, for operations on the gastro-oesophageal junction. In regard to colorectal disease, all major procedures have been shown to be technically feasible through a laparoscopic or laparoscopically assisted approach. It appears that the advantages of minor access surgery, such as less postoperative discomfort and shorter hospitalization, apply to colorectal operations as well. An area of dispute is the application of the laparoscopic approach to colorectal carcinoma. Therefore, any presentation of available data is of interest to workers in this field. This volume constitutes the proceedings of an expert meeting on this new and rapidly developing area of surgery.