Avoiding Complications in Laparoscopic Colorectal Surgery

The art of minimal access surgery has slowly, but surely, penetrated the forbidden realms of oncologic surgery. Forbidden - because the early reported incidence of port site metastases and the lack of higher degree of skill needed to perform these major procedures were associated with a high incidence of complications. Today, with the growing understanding of the physiological changes associated with the use of laparoscopy, the improved training imparted across the world, realisation of simple principles like careful insulation of the cautery to avoid accidental burns to the surrounding bowel, as well as, better techniques for retrieval of the surgical specimen have brought laparoscopic surgery for colorectal cancer to the next level with reports of comparable, and sometimes, even better results than open surgery. As laparoscopic surgery has become a widely accepted procedure for colon cancer we revisit the complications encountered and attempt to provide tips on how to prevent these injuries. The higher incidence of complications, resection margin positivity, and higher conversion rates reported in case of rectal cancer do not justify its routine use outside the realm of clinical trials.