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World J Gastroenterol. May 7, 2014; 20(17): 4926-4933
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.4926
Evolution of laparoscopy in colorectal surgery: An evidence-based review
Alexander Emmanuel Blackmore, Mark Te Ching Wong, Choong Leong Tang
Alexander Emmanuel Blackmore, Mark Te Ching Wong, Choong Leong Tang, Department of Colorectal Surgery, Singapore General Hospital, Singapore 169856, Singapore
Author contributions: Blackmore AE and Wong MTC reviewed and analysed the literature and wrote the paper; Tang CL reviewed and revised the manuscript.
Correspondence to: Mark Te Ching Wong, MBBS, FRCS, Consultant Surgeon, Department of Colorectal Surgery, Singapore General Hospital, 20 College Road, Academia, Outram Road, Singapore 169856, Singapore. mark.wong@sgh.com.sg
Telephone: +65-6-3214677 Fax: +65-6-2273787
Received: November 27, 2013
Revised: January 8, 2014
Accepted: January 20, 2014
Published online: May 7, 2014
Abstract

Open surgery for colorectal disease has progressed significantly over the past century from humble beginnings to form the mainstay of treatment for colorectal cancer and a number of benign conditions. Following the introduction of laparoscopic abdominal surgery, the next stage in the evolution of the specialty began in the 1990s with the first laparoscopic colonic resection. Following some early concerns regarding its safety and oncological efficacy during the latter part of that decade, laparoscopic colorectal surgery rapidly came into mainstream use in the early part of the current century with evidence supporting its use being made available from large scale randomised controlled trials. This article provides an evidence-based summary of this evolutionary process as it relates to both benign and malignant colorectal disease, as well as discussion of the next phase of new technologies such as robotic surgery.

Keywords: Colorectal surgery, Colorectal cancer, Pelvic floor, Laparoscopy, Robotics, Laparoscopic resection of gastrointestinal

Core tip: This article provides a historical perspective on the development of minimally invasive surgery for colorectal disease, as well as a summary of the key evidence supporting its use for treating both benign and malignant disease. We further discuss new minimally-invasive technologies which represent the next step in the evolution of colorectal surgery.