Laparoscopic Total Mesorectal Excision

Since the introduction of Total Mesorectal Excision (TME), two minimally invasive techniques have been developed and are currently used together with the classic open approach: laparoscopy and robotic surgery. The adoption of laparoscopy in colorectal oncologic surgery has not been fast and various factors have contributed to curb the change. Nevertheless, short-term benefits such as reduced length of stay, blood loss, and pain are now widely recognized as benefits of minimally invasive surgery. In contrast to laparoscopy, the expansion of robotic surgery has been more expedited. However, there is currently no scientific evidence of an advantage with this approach for rectal cancer surgery, while several studies have shown a considerable increase of OR time and costs. T his manuscript aims to summarize the history of laparoscopic colorectal surgery, describe the current techniques for laparoscopic TME and review the results of the published principal studies.