Laparoscopic colorectal surgery is a form of minimally invasive surgery that started in early 1990’s in Australia. However, it became more popular after 2004 when the result of a large US clinical trial was published demonstrating its advantages and safety in cancer surgery.
Laparoscopic colorectal surgery has the following advantages:
Short Term Advantages
- Quicker recovery
- Less pain and thus need less pain relief
- Drink and eat earlier
- Open bowel earlier
- Shorter hospital stay
- Less complications
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Long Term Advantages
- Better cosmetic result for the wounds
- Lower risk of small bowel obstruction in the future
- Lower risk of incisional hernia
Hand-Assisted Laparoscopic Colectomy
This type of minimally invasive surgery was developed in the late 1990s in the USA. Dr Chew developed his own techniques to suit the Australian environment in 2004-2005. The advantages of this minimally invasive surgery technique compared to pure laparoscopic technique are outlined below:
- Reduces operating time
- Makes the operation easier to perform
- Reduces the chance of converting the operation to an open colectomy due to difficulties encountered during operation, this then avoids all the disadvantages of an open colectomy
- Hand-assisted laparoscopic colectomy can be applied to more complex cases
- It also keeps all the above-mentioned short and long term advantages of a laparoscopic colectomy
Caption: HALC scar
Laparoscopic Colorectal Surgery has evolved significantly since the 1990s. In the last few years, we have seen major advances in laparoscopic rectal cancer surgery. They are robotic-assisted rectal cancer surgery and transanal total mesorectal excision (taTME), i.e. laparoscopic surgery to free up the lower part of the rectum via the anus. taTME has been shown to provide a better margin around the cancer, thus reduce the chance of the cancer recurrence.