LAPAROSCOPIC-ASSISTED SEGMENTAL COLECTOMY - EARLY MAYO-CLINIC EXPERIENCE

Objective: To present a large initial series of patients who underwent laparoscopic-assisted segmental colectomy and to assess the feasibili ty and safety of this procedure. Design: We summarized the clinical ou tcome data for 122 Mayo Clinic patients selected for laparoscopic-assi sted resection of the right, left, or sigmoid colon between 1991 and 1 993. Material and Methods: Preexisting factors (such as obesity and pr ior abdominal operations), indications for surgical treatment, and int raoperative and postoperative complications were analyzed statisticall y in two groups of patients-those in whom the laparoscopic procedure w as completed and those in whom conversion to an open surgical techniqu e was necessary. Results: Laparoscopic-assisted colectomy was successf ully completed for a variety of colonic pathologic conditions, includi ng polyps, cancer, and diverticulitis. No operative deaths occurred in this series, and the overall complication rate was low (11%). Patient s in whom laparoscopic-assisted colectomy was completed had a more rap id return of bowel function and a briefer hospital stay than did those who required conversion to the traditional open surgical technique. N either obesity nor previous abdominal surgical procedures precluded su ccessful laparoscopic-assisted colectomy, although the conversion rate to open colectomy was 75% in patients whose weight exceeded 90 kg. Co nclusion: These findings indicate that laparoscopic-assisted segmental colectomy is safe and feasible, and the procedure may offer patient-r elated advantages. Oncologic concerns, including recent reports of tro car site recurrences, suggest a cautious approach to its application f or resection of colonic cancer.