Advantages and Disadvantages of Laparoscopic Colorectal Surgery
A responsible approach to developing new surgical techniques must consider the risks and benefits of the techniques at every point so surgical outcome is constantly maximized for all patients undergoing the new surgical treatment. The simple fact that a surgical technique can be performed does not justify its use. Laparoscopic techniques in gallbladder surgery clearly benefit the patient: there is less reduction in pulmonary function,1–3 probably less postoperative pain,4–7 and much faster recovery8 after laparoscopic cholecystectomy as compared with conventional cholecystectomy. These benefits are so evident that a prospective randomized trial to demonstrate them will probably never be performed. Despite the advantages of laparoscopic gallbladder surgery, it is not obvious why surgeons should adopt these techniques for colorectal surgery. Unlike surgery for gallbladder disease, surgical treatment of abdominopelvic disease often requires extensive mobilization and removal of a large section of intestine—it could be argued that the direct and wide exposure that the long abdominal incisions used in conventional surgery provides might outweigh other benefits of laparoscopic surgery.
KeywordsPulmonary Function Laparoscopic Cholecystectomy Intestinal Motility Conventional Surgery Postoperative Ileus
Unable to display preview. Download preview PDF.
- 5.Ure BM, Troidl H, Spangenberger W, Dietrich A, Lefering R, Neugebauer E. Pain after laparoscopic cholecystectomy. Surg Endosc. 1994;8:90–96. Google Scholar
- 17.Sarna SK. Physiology and pathophysiology of colonic motor activity. Part one of two. Dig Dis Sci. 1991; 31: 827–862.Google Scholar
- 18.Sarna SK. Physiology and pathophysiology of colonic motor activity. Part two of two. Dig Dis Sci. 1991; 31: 998–1018.Google Scholar
- 35.Donovan K, Swanson-Fisher RW, Redman S. Measuring quality of life in cancer patients. J Clin On-col. 1989; 7: 959–968.Google Scholar
- 44.Bush AK. The surgical implantation of tumors. Ann Surg. 1957; 23: 1012–1021.Google Scholar
- 45.Meadows C. Surgical transplantation of tumor cells. Ann Surg. 1957; 23: 247–256.Google Scholar