[Preliminary experience with minimally invasive colorectal surgery in a local surgical clinic]

The aim of the retrospective study is to present outcomes of introduction of minimally invasive colorectal surgical techniques in a local surgical clinic.

The author assessed the subjects indications for laparoscopic resections of the left hemicolon and rectum, according to the following criteria: diagnosis, age, ASA, BMI, preceeding intraabdominal procedures. Surgical tactics, techniques and locating diagnostic procedures are described in the study. Furthermore, duration of the procedures, postoperative complications and duration of hospitalization is recorded.

From October 2006 to April 2007, 12 subjects (6 males and 6 females) aged between 48 and 78 years, were indicated for laparoscopic resections of the colon and rectum. The diagnoses included rectal carcinomas (5x), sigmoid carcinomas (3x), a lienal flexure carcinoma (1x), relapsing diverticulitis of the sigmoid (2x) and a rectal prolaps (1x). ASA 2..7x, ASA 3..3x, ASA4..2x. In a single subject, the procedure was converted due to a voluminous rectal carcinoma. The laparoscopically completed procedures lasted for 156 to 317 minutes. Postoperative complications included: postanaesthetic respiratory depression, transient paresis of the n. radialis 1.dx., n. fibularis 1.dx. and contusion of the right thenar. The hospitalization duration ranged from 9 to 18 days. The number of removed lymphonodes in malignancies was from 3 to 11.

Conditions of a local surgery do not prevent safe introduction of laparoscopic colorectal procedures, providing thorough training is provided and the patients selected.