Laparoscopy for Crohn disease

The laparoscopic approach to Crohn disease offers the multiple potential benefits of faster recovery, better cosmesis, and a lower incidence of adhesion-related complications and incisional hernias. Most of these advantages are unproven, but a review of the current literature reveals that advantages have been suggested in almost all series that have compared laparoscopy to laparotomy. Some features of Crohn disease, such as fistula, abscess, and phlegmon, may pose a surgical challenge; however, laparoscopic resection is often feasible, with morbidity rates comparable to or lower than those associated with laparotomy. Experience both in advanced laparoscopic techniques and surgery for Crohn disease, coupled with sound surgical judgment and a reasonably low threshold to convert to laparotomy before intraoperative complications occur, are essential for the successful and safe employment of these procedures.