[When is laparoscopic surgery safe in cancer?]

In the Netherlands more than 75% of colorectal cancers are operated on laparoscopically. Randomised controlled trials and population-based studies, corrected for case mix, provide overwhelming evidence that the laparoscopic approach is superior to open surgery in the short term, and that long-term oncological outcomes are not inferior to those of open surgery. Therefore, the question should be rephrased. As laparoscopy should be considered the new gold standard, who still needs open surgery? Probably only the unhappy few with locally advanced tumours and adhesions.