ABSTRACT
In comparison with open colorectal surgery, laparoscopic surgery is still a relatively recent development, the first laparoscopic colectomies being undertaken in the early 1990s. However, in many units, laparoscopic colorectal surgery is undertaken in larger numbers than open surgery, at least for elective procedures. The evolution of the laparoscopic era has presented challenges to surgical training, demanded rigour in audit and required surgeons to recognise their technical limitations. Deciding on a surgical approach begins with considering in detail what the surgery will involve, particularly for colorectal resections. Anatomical details, past surgical history and medical co-morbidities are all taken into account. Laparoscopy offers the opportunity for a magnified optical view within the immediate vicinity of the point of dissection or division of tissue. Tactile feedback, often valuable in identifying planes for dissection and judging safe retraction, is limited in laparoscopic surgery.
