Overview of Procedure


Laparoscopic colorectal resection was first performed in 1991.([FOOTNOTE=Fowler DL, White A. Laparoscopy-assisted sigmoid resection. Surg Laparosc Endosc. 1991 Sep;1(3):183-8.],[ANCHOR=],[LINK=]),([FOOTNOTE=Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc. 1991 Sept;1: 144–150.],[ANCHOR=],[LINK=])  Initially, when used for removal of tumors in patients with colorectal cancer there was concern over the high incidence of port-site metastases. This has now largely been negated due to improved technique isolation of diseased tissue prior to extraction and rates of port site metastases with laparoscopic colectomy are now similar to rates of metastases around the edge of the wound site reported with open colectomy.([FOOTNOTE=Lacy AM, Delgado S, García-Valdecasas JC, et al. Port site metastases and recurrence after laparoscopic colectomy. A randomized trial. Surg Endosc. 1998 Aug;12(8):1039-42.],[ANCHOR=],[LINK=]),([FOOTNOTE=Bărbulescu M, Alecu L, Boeţi P, Popescu I. Port-site metastasis after laparoscopic surgery for colorectal cancer--still a real concern? Case report and review of the literature. Chirurgia (Bucur). 2012 Jan-Feb;107(1):103-7.],[ANCHOR=],[LINK=]),([FOOTNOTE=Martel G, Crawford A, Barkun JS, et al. Expert opinion on laparoscopic surgery for colorectal cancer parallels evidence from a cumulative meta-analysis of randomized controlled trials. PLoS One. 2012;7(4):e35292.],[ANCHOR=],[LINK=])  Laparoscopic colectomy has several benefits compared with open colectomy and is becoming increasingly widely used across both developed and emerging markets. However, as operating time is typically longer with laparoscopic colectomy versus open there is demand in some settings to demonstrate tangible clinical benefit and cost-effectiveness of the use of laparoscopic techniques.

US data show that 37% of laparoscopic colectomies are performed in patients with primary malignant neoplasm, 29% for diverticular disease and 19% for benign neoplasms([FOOTNOTE=Wilson MZ, Hollenbeak CS, Stewart DB. Laparoscopic colectomy is associated with a lower incidence of postoperative complications than open colectomy: a propensity score-matched cohort analysis. Colorectal Dis. 2014 May;16(5):382-9.],[ANCHOR=],[LINK=]) and in 2015 there will be an estimated 132,700 cases of colorectal cancer in the United States, which represents 8% of total cancer cases in the US making it the fourth most common cancer.([FOOTNOTE=SEER Stat Fact Sheets. Colon and Rectum Cancer. National Cancer Institute (United States) Website. Accessed July 27, 2015.],[ANCHOR=View Stat Facts],[LINK=http://seer.cancer.gov/statfacts/html/colorect.html ])  Surgery (laparoscopic or open) is the only curative treatment for colorectal cancer and encompasses complete resection of the primary tumor with negative margins in addition to a complete oncologic lymphadenectomy.