REVIEW   

Minerva Chirurgica 2015 August;70(4):257-72

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Minimally invasive techniques to decrease the impact of colorectal surgery for neoplasia

Saur N. M., Wexner S. D. ✉

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA

Minimally invasive colorectal surgery has evolved over the past few decades. Techniques currently in practice to decrease the impact of colorectal surgery for neoplasia include laparoscopy and its derivations, robotic surgery, transanal endoscopic surgery (TES), transanal total mesorectal excision (taTME), natural orifice specimen extraction (NOSE), needlescopic surgery, and advanced endoscopy. Many of the new techniques are variations of standard laparoscopy that aim to decrease the size of the incisions (needlescopic surgery), decrease the number of incisions (single-incision laparoscopic surgery, SILS), or eliminate the need for a specimen extraction incision (taTME). Each variation must be evaluated for safety and efficacy, especially in oncologic outcome. It is imperative that clinicians understand the role and limitation of each minimally-invasive technique. The goal moving forward should be to develop and sustain technology that is safe, effective, and offers superior clinical outcomes when compared to the current gold standards.