LAPAROSCOPIC TECHNIQUES - WHAT IS THE ROLE IN INFLAMMATORY BOWEL-DISEASE

Laparoscopic cholecystectomy has quickly become the preferred techniqu e for removing the gallbladder. Real advantages in the area of laparos copic gallbladder removal have spurred interest towards other areas of laparoscopic surgery. There has been interest in laparoscopic bowel s urgery but this approach has not gained popularity as quickly as gallb ladder surgery. Reasons surround the fact that the bowel is a continuo us organ (versus an end organ like the gallbladder) laden with bacteri a and it has a rich blood supply. These differences make laparscopic b owel surgery more difficult and challenging. If inflammatory bowel dis ease (IBD) is considered, the indications to approach surgery laparosc opically fall into two categories: current and future indications. The current indications are diagnostic laparoscopy, fecal diversion, limi ted bowel resections with extracorporeal anastomosis and stoma closure s. Future indications include laparoscopic subtotal colectomy and lapa roscopic assisted pelvic pouch procedures. As experience is gained and laparoscopic instruments are modified and refined for bowel surgery, intracorporeal anastomosis and more extensive bowel resections will be feasible. Currently laparoscopic bowel surgery can be done in select circumstances for problems associated with IBD. It has yet to be prove n if doing the surgery laparoscopically provides advantages for bowel surgery as has been demonstrated with gallbladder surgery. Prospective studies are underway to answer these question.