Initial experience with 150 cases of laparoscopic assisted colectomy

Background: Despite multiple reports of large series in the literature over the past decade, laparoscopic assisted colectomy (LAC) has not received widespread acceptance by the surgical community. Critics of LAC note concerns regarding unproved benefits and increased complexity of the procedures. The authors report their initial experience with 150 procedures. Methods: A retrospective review of 150 consecutive LACs was performed by the authors. Results: Mean operative time for completed LAC, converted procedures, right, and sigmoid resections were 164 minutes, 203 minutes, 121 minutes, and 177 minutes, respectively. Twenty-two patients had additional concurrent laparoscopic procedures. Thirty-nine patients had undergone previous abdominal surgery. The conversion rate was 12%. Mean length of stay for all patients was 4.5 days. There were 8 major and 16 minor complications. There were no port site metastases. Major complications and conversion rate decreased from the first 50 cases to the last 50 cases. Conclusions: LAC can be safely performed with superior quality of life outcomes in comparison with open colectomy. The authors believe that LAC will eventually become the gold standard for colon resection. The learning curve is discussed as an ongoing process, rather than a set number of procedures.