postheadericon Minimally Invasive Colorectal Surgery

Each year, more than 600,000 surgical procedures are performed in the United States to treat a number of colon diseases. Patients undergoing traditional “open” colon surgery often face a long and difficult recovery, Colorectal surgery as these procedures are highly invasive and often require long midline incisions. Surgery results in an average hospital stay of a week or more and usually 6 weeks of recovery.

In 1990, minimally invasive techniques were introduced to the field of colorectal surgery with the performance of the first laparoscopic right hemicolectomy. Within a year, surgeons began using minimally invasive techniques to treat a variety of colorectal diseases. Today, virtually all colon and rectal diseases amenable to surgical treatment can be approached laparoscopically. Right, left, and low anterior colon resection for colon polyps and cancer; ileostomy and colostomy creation and closure; sigmoid resection for diverticulitis; and proctocolectomy with ileoanal J-pouch formation for ulcerative colitis are all performed regularly at both academic and community centers using laparoscopy. The indications for surgery are the same, whether the approach is through a standard incision or by laparoscopic technique. In fact, most patients can be considered candidates for a laparoscopic approach, even those with a history of abdominal surgery.

Numerous reports have since been published which show the benefits of laparoscopic colorectal procedures over the conventional open approach including fewer wound complications, less postoperative pain, faster recovery times, shorter hospital stays, reduced need for blood transfusions, earlier return of bowel
function, possible immune benefits, and smaller scars.

Minimally invasive colorectal surgery continues to evolve and includes not only “pure” laparoscopic techniques, but also hand-assist devices. Use of a hand-assist device decreases the learning curve associated with laparoscopy, provides tactile feedback for the surgeon, and shortens operating-room time while still preserving many of the advantages of laparoscopic surgery. By combining laparoscopic surgery with the tactile feedback of a hand-assist device, surgeons can reduce operating-room time and have a lower procedure conversion rate. Several clinical trials have demonstrated that there is no difference in patient recovery or discharge for laparoscopic versus hand-assisted techniques.

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