| Theme |
What endoscopists should know about laparoscopy-assisted colectomy |
| Title |
Laparoscopic surgery for early colorectal cancer -- indications and surgical procedures |
| Author |
Jun-ichi Tanaka |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shungo Endo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Koichi Nagata |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Akiko Umezawa |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Michiaki Iwashita |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Eiji Hidaka |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hidenobu Ishizaki |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Haruhiro Inoue |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yoshiro Tamegai |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
Recent developments in minimal access surgery have altered the surgical approach to colorectal surgery so that the laparoscopic or assisted colorectal resection (LAC) appears to be a very attractive alternative to open surgery. We demonstrated our indications and surgical procedures for laparoscopic surgery for early colorectal cancer, especially in sigmoid colon cancer and rectal cancer. Magnifying colonoscopy and pit pattern diagnosis are proper and feasible in diagnosis of early colorectal cancer and the depth of cancer invasion. Those cases in which the depth of the cancer invasion is limited to the upper third of the submucosal layer can be resected with colonoscopy, however other early colorectal cancer should be treated using LAC procedures including lymphnode dissection. We demonstrated laparoscopic techniques for low anterior resection of the rectum with pelvic truncal autonomic nerve preservation, and also an intracorporeal double stapling technique, using an endoscopic linear stapler and a circular stapler. Those undertaking this type of surgery must have adequate experience in open surgery as well as laparoscopic experience with benign diseases prior to approaching this treatment for carcinoma. |