Sajida Ahad, MD; Edgar J. Figueredo, MD; Brant K. Oelschlager, MD Series Editors: Brant K. Oelschlager, MD; Carlos A. Pellegrini, MD


May 16, 2007


Since the first laparoscopic cholecystectomy was performed in 1985, advances in minimally invasive techniques and equipment have permitted safe and more advanced operations to be performed. Minimally invasive colon surgery has not been embraced with the same enthusiasm as laparoscopic cholecystectomy. Some of the concerns regarding laparoscopy were based on early reports of port site recurrence of colon cancer. Open colectomy was considered the cornerstone operation, especially for colorectal neoplasia. Compared with open colectomy, laparoscopic colectomy has been shown to be associated with decreased postoperative analgesia requirement, faster return of bowel function, earlier resumption of oral intake, shorter hospital stay, and better cosmesis. However, these benefits come at the cost of slightly prolonged operative time and associated expense. In addition, surgeons who perform these operations need more advanced laparoscopic skills and training.

A 55-year-old man had a 2-cm polyp with invasive cancer found during routine surveillance colonoscopy. He is worried about the risk of recurrence if a laparoscopic approach is used. Which of the following statements is true?

  1. Laparoscopic surgery is associated with a higher recurrence rate of cancer than open surgery

  2. Laparoscopic surgery should never be used for cancer; it is indicated only for benign disease

  3. The laparoscopic approach is an acceptable and safe alternative to open surgery

  4. The polyp should be resected via an endoscopic approach

View the correct answer.