Laparoscopic resection of colorectal cancer.

Laparoscopic surgery has revolutionised procedures such as cholecystectomy since its inception in the 1980s. After initial enthusiasm with laparoscopic colorectal resections in the early 1990s, resection of colorectal malignancy was largely abandoned outside clinical trials because of reports of inferior oncological outcomes including local and port-site recurrence. More recently, however, an increasing number of reports have demonstrated that laparoscopic surgery for colorectal cancer though technically demanding is feasible, and the results of large multi-centred randomised trials showing oncological equivalence are becoming available. Technological advances in laparoscopic equipment along with the increasing skills and experience of laparoscopic surgeons have extended the indications and reduced the contraindications for laparoscopic colectomy. This, along with the use of fast- track protocols is changing the way we manage patients. The future of laparoscopic colorectal surgery is assured, driven not only by the physical benefits to the patient in the short and medium term, the reduced financial burden on in-patient stay, and post-operative return to work, but also increasing patient demand. This in turn requires that surgeons should ensure high quality training and operative competence to maintain the high standards achieved by the pioneers in this field.