Unité de chirurgie colorectale, clinique universitaire de chirurgie digestive et de l’urgence, hôpital Albert-Michallon, BP 217, 38043 Grenoble cedex 09, France
Total mesorectal excision reduces the local recurrence rate after excision of rectal cancer. Laparoscopic excision has several technical advantages including better view of the lower rectum through the camera, more accurate dissection of the rectum, pain minimization, reduced hospital stay, reduced rates of parietal complications and smaller surgical scars. Technical disadvantages of the technique include the impossibility to perform palpation of abdominal organs, rectum or mesorectum and the need for a training period. Data gathered from the first studies done in expert centers indicate that there are no oncologic differences between laparoscopic and open resections for treatment of primary rectal cancer.