ENHANCING COSMESIS IN LAPAROSCOPIC COLON AND RECTAL SURGERY

PURPOSE: The only unanimously accepted advantage of laparoscopic colon and rectal surgery, at present, is cosmesis. Techniques to enhance co smesis in laparoscopic surgery are presented. METHOD: Careful and meti culous placement of laparoscopic ports and incisions enhance the cosme tic effect of the procedure. Determination of port sites is aided, in part, by preoperative assessment of natural skin folds and creases by a stomatherapist. Intraoperative techniques include placement of ports directly through the umbilicus, previous incisions, and natural skin folds and creases. RESULTS: These techniques have been practiced with no complications or added morbidity. Safety and good access during the procedure is not compromised. The cosmetic effect in laparoscopic sur gery is enhanced. CONCLUSION: Techniques to enhance cosmesis in laparo scopic surgery can be practiced safely and efficiently. Surgeons shoul d make an effort to focus on this benefit, when possible.