Laparoscopic colorectal surgery in progress

Nearly all standard colorectal operations have been attempted by the laparo scopic method. While bowel surgery is substantially more difficult it is pr oven feasible for most operations but its spread is slow. Less than 5% of a ll abdominal colorectal surgery is done laparoscopically a proportion which may rise to 20% in departments with a special interest. The complexity of the operation demands the learning of new skills which it will not be possi ble for all currently active colorectal surgeons to acquire. The learning p hase is substantial, especially for resections, and yet the operation time remains about an hour longer than that of the open operation. Laparoscopic colorectal surgery is a fascinating subject because of its technical conten t, rapid change, and vitalisation of surgical thinking with profound reperc ussions on traditional operative technique. After seven years of breaking n ew ground it is time for the laparoscopic colorectal surgery to progress fr om a demonstration of what is possible to demonstrate when laparoscopy prod uces consistently better results at acceptable cost.