The use of laparoscopic techniques in surgery for mucosal ulcerative colitis.

The use of laparoscopic techniques when surgical therapy is required for the treatment of mucosal ulcerative colitis has been slow to develop; the surgery is extensive, and the instruments are limited. The often urgent nature of the surgery, along with the fragile inflamed colon, have contributed to the limited development of this surgical approach. Yet there is a paradox, as these patients have often anticipated surgery and thus are extremely frightened about it, or must undergo a major operation under urgent circumstances. In this setting, it would seem that a minimally invasive surgical approach would make sense if safe and reasonable, because healing, scarring, and patient fears can be minimized. We are encouraged by the experience we have gained over the past several years in performing these complex laparoscopic cases. The development of some of the newer surgical technologies has shortened operative times. Several recent studies have demonstrated short-term advantages with the laparoscopic approach compared with standard open operations for mucosal ulcerative colitis. Thus, this new approach is a viable and valuable option that may be offered to some patients with mucosal ulcerative colitis.