[Localization of colonic tumor in laparoscopic surgery. Intraoperative colonoscopy or preoperative tattoo]

Tumor localization may be critical in laparoscopic surgery because manual palpation may not be possible. This study focused on the need for intraoperative colonoscopy to identify the tumor site. We also present our preliminary experiences with preoperative tattoo of the resection site.

A prospective, consecutive, consecutive study of 61 patients operated on laparoscopically for colonic tumor together with 9 patients with preoperative tattoo of the resection site (5 laparoscopic and 4 open operations) was done.

Intraoperative colonoscopy was necessary to identify the tumor site in 23% of the 61 patients without preoperative tattoo. Tumor grading and localization in this group did not differ from that in the group where colonoscopy was not needed (p>0.05). The median operation time was significantly longer in the group in which intraoperative endoscopy was performed (p<0.05). The preoperative tattoo caused no complications, and the tattoo was visible in all 9 patients intraoperatively.

Almost one fourth of the patients operated on laparoscopically for colonic tumor needed intraoperative colonoscopy to identify the tumor site. This impeded the laparoscopic operation, prolonged the operation time and increased the potential risk for infectious complications. Preoperative tattoo, which renders intraoperative colonoscopy superfluous, should therefore be considered for all patients operated on laparoscopically for colonic tumor, as it is difficult to determine in advance the patients in whom the tumor site will be hard to identify intraoperatively.