Laparoscopic restorative proctocolectomy technical notes and postoperative results

Laparoscopic colon surgery has become a proved method for the resection of both benign and malignant disease. With the advance of technological innovations and surgical experience, more complex laparoscopic procedures including restorative proctocolectomy have become increasingly used in the treatment of ulcerative colitis with safe and feasible results. When these operations are realized in a stepwise fashion, the complexity of the procedure becomes simplified. The technical aspects of laparoscopic restorative proctocolectomy in patients with ulcerative colitis are reviewed in this article. A J-pouch with a stapled anastomosis has been the preferred technique because it is quicker and safer. In all patients diverting loop ileostomy is regularly created at the time of ileal pouch-anal anastomosis. In this review the postoperative results are also revised. Postoperative fasting time, postoperative hospital stay, and overall complication rate are in favor of laparoscopic technique when compared to open approach. However, clinical value of laparoscopic surgery for ulcerative colitis needs further evaluation with more well-designed randomized controlled trials along with long-term follow-up.