Laparoscopic sigmoid colectomy: total laparoscopic approach.

Laparoscopic surgery seems set to make a significant impact on the practice of colorectal surgery. However, to date, the majority of surgeons have used a technique of laparoscopic assistance whereby initial laparoscopic mobilization of the bowel is followed by extracorporeal mesenteric and bowel division and subsequent restoration of bowel continuity. This report describes a technique of totally laparoscopic left-sided colonic resection, transanal specimen delivery, and intracorporeal colorectal anastomosis. The technique employed is described in detail and the indications and controversies surrounding such an approach are discussed.