Less Pain, Quick Recovery, Same Cure
The 1980s heralded the development of laparoscopic general surgical procedures, with the first laparoscopic cholecystectomy being performed by Mühe in Germany on September 12th 1985. This was followed in 1991 by the first reports of colonic resection performed with laparoscopic assistance by Jacobs in Miami, Florida, and separately by Fowler in Kansas.
The subsequent advancements in laparoscopic technology resulted in the development of a variety of new instruments that have allowed increasingly complex procedures to be performed in a safe and efficient manner. Further advancement of laparoscopic surgery is robotic surgery, wherein the robot helps the surgeon in performing laparoscopic surgery reducing the surgeon’s effort.
Like every new technology the efficacy of laparoscopy was also questioned in the beginning. However, laparoscopic colorectal surgery rapidly came into mainstream use in the early part of the current century with overwhelming evidence supporting its use came from large scale randomised controlled trials.
As technology and evidence from scientifically conducted research grew, cancer surgeries of every organ in the body is being performed laparoscopically or robotically.
What, therefore, are the advantages of laparoscopic compared to open colorectal surgery? The smaller incisions required for insertion of laparoscopic ports obviously result in less surgical trauma to the abdominal wall, and studies have demonstrated a reduced inflammatory response, possibly as a result of less manipulation of the small intestine during surgery. There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. Pain and bleeding are reduced due to smaller incisions and, the recovery time is shorter.
The advantages of minimally invasive surgery may translate better care quality for oncological patients and lead to increased cost saving through the introduction of active enhanced recovery programs which are likely cost-effective from the perspective of the patients.