Operating Room Setup and General Techniques in Minimal Invasive Colorectal Surgery

Abstract

Minimally invasive techniques have demonstrated tangible benefits to patients in terms of diminished postoperative pain, reduction in postoperative ileus, earlier tolerance of a diet, diminished hospital stay, earlier return to normal activities, and improved cosmesis. These benefits, however, are offset partially by the presence of an established learning curve (>20 cases) ascribed to obtaining proficiency in minimally invasive colon and rectal surgery. Additionally, laparoscopic and robotic operations are associated with increased operating room times and requisite operating room costs. These disadvantages are most evident early in a surgeon’s minimally invasive practice, namely, until one has attained efficiency and an adequate case volume in laparoscopic and robotic surgery to employ minimally invasive techniques proficiently. Despite these drawbacks, minimally invasive colon and rectal operations have been shown to be cost-effective and clearly offer numerous patient-centered benefits when compared to open operations. Central to attaining proficiency in minimally invasive colon and rectum surgery is obtaining an understanding of the proper operating room setup, necessary specialized equipment and instrumentation, as well as a basic understanding of patient positioning for these operations. As such, these topics form the basis of this chapter.