Laparoscopic and Minimally Invasive Resection of Malignant Colorectal Disease
ABSTRACT Minimally invasive surgery for colorectal cancer is a burgeoning field of general surgery. Randomized controlled trials have assessed short-term patient-oriented and long-term oncologic outcomes for laparoscopic resection. These trials have demonstrated that the laparoscopic approach is equivalent to open surgery with a shorter hospital stay. Laparoscopic resection also may result in improved short-term patient-oriented outcomes and equivalent oncologic resections versus the open approach. Transanal excision of select rectal cancer using endoscopic microsurgery is promising and robotic-assisted laparoscopic surgery is an emerging modality. The efficacy of minimally invasive treatment for rectal cancer compared with conventional approaches will be clarified further in randomized controlled trials.
- SourceAvailable from: Igor Monsellato
Colorectal Cancer - From Prevention to Patient Care, 02/2012; , ISBN: 978-953-51-0028-7
- "Minimally invasive techniques have revolutionized general surgery, especially in the field of gastrointestinal surgery. Many authors argue that the era of laparoscopic technique had begun in 1987, when Mouret performed the first laparoscopic cholecystectomy (Koopmann et al., 2008; Law et al., 2007). Since that point, laparoscopic technique has become the first choice for a multitude of surgical procedures: cholecystectomy, gastric bypass, fundoplication and its variants are some examples of procedures which are currently performed laparoscopically (Stage et al., 1997; Lacy et al., 2002). "
- [Show abstract] [Hide abstract]
ABSTRACT: Purpose: Laparoscopic colectomy has been reported as a safe and oncologically similar operation to open colectomy. A number of expensive surgical instruments are necessary for the procedure which should be applied if it is cost-effective for the patient and the health system in general. The purpose of the current study was the economic evaluation of laparoscopic compared to open colectomy for the treatment of colon cancer in the Greek national health system. Methods: Fifty patients undergoing open colectomy and 42 undergoing laparoscopic colectomy were enrolled in this case-control study. Length of hospital stay, duration of operation, complication rates, cost of equipment used, total costs and three questionnaires measuring quality of life /QoL (EQ-5D, SF-36 and QLQ-C30) at baseline, 1 and 3 months after the operation were recorded. Results: No statistically significant difference in QoL measured by QALYs between laparoscopic and open colectomy was observed. On the other hand, cost utility analysis revealed that laparoscopic colectomy was more expensive considering the advantages it offers. Conclusions: Laparoscopic colectomy is not superior to open colectomy on a QoL basis in the Greek public hospital system and is less cost-effective compared to the open procedure. Since the expensive equipment used in laparoscopic colectomy seems to be the causative factor for the high cost of this type of operation, an effort should be made to reduce it either by using reusable instruments or by implementing policies aiming at suppliers cutting down equipment charges.Journal of B.U.ON.: official journal of the Balkan Union of Oncology 18(1):86-97. · 0.71 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Robotic surgery has many features that make it superior to traditional laparoscopic surgery. However, the use of the robot is limited by the need to reposition the robot during colon and rectal operations encompassing more than one abdominal quadrant. A "hybrid" technique has been developed which combines traditional laparoscopy with a robotic pelvic dissection. With this combined approach, the benefits of the 2 techniques can be maximized, while minimizing their limitations.Seminars in Colon [amp ] Rectal Surgery 12/2009; 20(4):181-184. DOI:10.1053/j.scrs.2009.08.007