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Updated: Jun 29, 2026

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
[Laparoscopic surgery for colonic cancer: present status and evaluation]
Masazumi Okajima1, Satoshi Ikeda, Hiroyuki Egi
1Department of Endoscopic Surgery and Surgical Science, Hiroshima University Graduate School of Biomedical Sciences.
Laparoscopic surgery for colon cancer has advanced significantly, with pure laparoscopic techniques and medial dissection becoming standard. A new qualification system and ongoing trials aim to ensure consistent, high-quality surgical skills for better patient outcomes.
Area of Science:
- Gastrointestinal surgery
- Surgical oncology
- Minimally invasive surgery
Context:
- Laparoscopic surgery for colon cancer has evolved over 15 years.
- A 2003 Japan Society of Endoscopic Surgery (JSES) analysis revealed increasing use of laparoscopic colonic resections.
- Advanced cancer cases surpassed early-stage cases in 2003.
Purpose:
- To analyze the trends and technical advancements in laparoscopic surgery for colon cancer.
- To introduce the Endoscopic Surgical Skill Qualification System (ESSQS) for safer procedures.
- To initiate a Japanese trial for quality control of surgical skills.
Summary:
- Pure laparoscopic approaches and medial dissection are favored over hand-assisted laparoscopic surgery (HALS) and lateral dissection.
- The ESSQS evaluates surgical skill and oncologic handling through video review.
- A multicenter trial is underway to standardize surgical skill levels.
Impact:
- The ESSQS promotes safer laparoscopic surgery in Japan.
- Standardization of surgical skills is expected to reduce performance variability.
- Advancements aim to improve patient outcomes in laparoscopic colon cancer treatment.
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