Concepts in Training & Setup for Laparoscopic Colorectal Surgery

  • Emre Balık

Turk J Colorectal Dis 2007;17(1):36-45

In the year 1902, a German surgeon named George Kelling visualized the abdominal cavity of dogs using his own individual laparoscopic technique. Despite this important step taken in all time medical history, the development and wide spread practice of minimal invasive surgery could only be achieved recently in the last 25 years due to the evolutions in medical technology. The concept of advanced laparoscopic surgery has become a current issue thereafter. Along with these events, Moises Jacobs et al. reported their first series of laparoscopic resections for colon cancer. Finally, in the last 10 years, thousands of laparoscopic resections for colon and rectal cancer have been performed successfuly. In this respect, EAES and SAGES categorized the laparoscopic operations as “basic laparoscopic surgery” and “advanced laparoscopic surgery”. From this point of view; appendectomy, cholecystectomy and diagnostic laparoscopic procedures are accepted to be basic laparoscopic operations, whereas all other types of surgical interventions are in the extent of advanced laparoscopic surgery. These concepts brought about the two crucial questions: 1) Under which circumstances and by whom should these techniques be performed? 2) By whom and how should the surgeons be trained in order to perform these techniques? In July 2006, SAGES and ASCRS published a guideline for the standardization of training for laparoscopic colorectal surgery. The objective of this report is to explain the concepts in training and setup for laparoscopic colorectal surgery and, in general, provide answers to the two questions mentioned above.