Laparoscopic Resection for Colorectal Cancer: Limitations and Concerns

Laparoscopic skills and perceptions are an increasing part of the "surgical commonsense" of the younger surgeon. The part played by the laparoscope in colorectal surgery will thus increase gradually over the coming years, and this process is unlikely to be prevented by widespread doubts and scepticism, which are quite properly applied at this time to cancer surgery. Nevertheless, permanent cure and the absence of a stoma-thus, the avoidance of autonomic nerve damage-remain far more important to the patient than any of the advantages so far conferred by the laparoscopic approach. However, there is a possibility that improved visualization low in the pelvis, particularly with the development of newer and better instruments, will actually facilitate better dissection and more accurate deep pelvic surgery than has been possible by open surgery in the past.