Laparoscopic surgery for benign colorectal disease

Since 1991 when the first cases of laparoscopic colectomy were reported, this technique has become widespread in colorectal surgery. Its reliability in colorectal cancer has been demonstrated but indications must still be limited to strictly controlled clinical trials that will determine its impact in terms of cancerology outcome. Inversely, for benign colorectal disease, the efficacy, low morbidity and the generally observed clinical benefit of laparoscopy compared with laparotomy, particularly in terms of patient comfort in the post-operative period and delay to normal activities, has been clearly demonstrated in several, though too often uncontrolled, trials. Laparoscopy will thus become more and more widespread and probably predominant for benign colorectal disease. Today, it is warranted to propose first-intention laparoscopic procedures for elective diverticulitis sigmoidectomy, for ileocecal resection for Crohn's disease, for derivation stomies, and finally, for surgical ablation of voluminous colonic polyps. In hands well trained in laparoscopic and colorectal surgery, laparoscopic procedures will be proposed in the near future for total colectomy, rectopexia, or even ileo-anal anastomosis.