Minimum Invasive Colorectal Surgery

Satoru Takayama, PhD, Yasumasa Hara, PhD, Mikinori Sato, PhD, Hiromitsu Takeyama, PhD. Gastrointestinal Surgery of Nagoya City University

In recent years, similar to other surgical procedures, smaller and lesser incisions are required in the field of laparoscopic colorectal surgery. Such less invasive operations toward a new technique which is known as natural orifice transluminal endoscopic surgery (NOTES) is being performed more frequently. Meanwhile, we had already performed two-port laparoscopic cholecystectomy more than 10 years ago and also used minimally invasive laparoscopic techniques in the colorectal area, such as three-port colectomy or pure-laparoscopic colectomy. In particular, as the Hybrid-NOTES, the colorectal lesion was removed transanally in some cases and sometimes with the use of the single incision laparoscopic surgery (SILS) port in recent years. The operative scars following this procedure was almost the same as that following laparoscopic cholecystectomy. Additionally, we have also performed laparoscopic right hemicolectomy with a small single incision using the flexible gastrointestinal scopic dissection technique, which is the same technique used during endoscopic submucosal dissection (ESD) or SILS. We have had good outcomes in these cases without major complications. This stream toward NOTES is inevitable and, therefore, we have to further update our skills, as well as develop new methodology for further minimally invasive colorectal surgery. We also believe that surgeons should be trained to simultaneously perform laparoscopy and endoscopy.