[Recent advance in laparoscopic-assisted colectomy for colon cancer]

Laparoscopic-assisted colectomy for colon cancer has been tried in these 5-6 years in Western countries. In Japan, this procedure has been used since about three years ago. In this country, the indication for laparoscopic-assisted colectomy has been either colonic adenomas or carcinomas in early stage which are not suitable for colonoscopic removal. The application of this procedure to more advanced carcinomas with invasion in the muscularis propria or invasion penetrating the muscularis propria is controversial. This is because of the technical difficulties involved in the lymph node dissection which is usual procedure for these invasive carcinomas in the usual laparotomy operation. We have carried out laparoscopic-assisted colectomy and lymph node dissection for colorectal carcinomas with invasion in the submucosa or deeper. In this study, we present the technical aspect of lymph node dissection in the laparoscopic procedure, and discuss the indication and technical problems in this procedure.