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Introduction: Laparoscopic colorectal resection is becoming the gold standard for treating colorectal cancers because it offers superior short‐term and comparable long‐time outcomes compared to open surgery. Intraoperative colonoscopy (IOC) is increasingly performed for tumor localization and mucosal assessment. The aim of this report was to review the safety and efficacy of IOC in laparoscopic colorectal surgery. Method: A MEDLINE search of studies of IOC in laparoscopic colorectal surgery was performed. We focused on three aspects of IOC use: (i) IOC for intraoperative tumor localization; (ii) colonic irrigation and IOC for obstructive left‐sided colorectal cancers; and (iii) IOC for assessing colorectal anastomosis. Results: During laparoscopic colorectal surgery, IOC enables accurate localization of early mucosal tumors, detection of lesions in the proximal unexamined colon for obstructive left‐sided cancer, and visual assessment of anastomosis. Additionally, IOC allows for proper surgical resection, management of concomitant lesions, immediate maintenance of hemostasis, suture repair of leaks, and the creation of a protective stoma as necessary. Conclusions: Intraoperative colonoscopy is beneficial in laparoscopic colorectal surgery. Experienced surgical endoscopists should be trained to safely perform IOC. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Tension‐free mesh repair is currently the gold standard treatment for inguinal hernia. Recent evidence has shown that both open and laparoscopic approaches to inguinal hernia repair can achieve good results. Lots of meshes with different properties are available on the market, but direct comparisons between them are scare. We conducted a prospective randomized controlled trial comparing a partially absorbable lightweight mesh (ULTRAPRO™) and a multifilament polyester anatomical mesh (Parietex™) in laparoscopic total extraperitoneal inguinal hernia repair. Methods: This study was a single‐center, prospective randomized controlled trial to compare the surgical handling and clinical outcomes between two different types of meshes. All operations were performed using a standardized operative protocol. This study was approved by the Institutional Review Board of the Hong Kong East Cluster Health Service in 2009 (reference number: 2009‐087). The study was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12610000031066). Results: From October 2009 to August 2011, 85 laparoscopic total extraperitoneal inguinal hernia repairs were performed. The mean mesh handling time was 152 s for the ULTRAPRO group and 206 s for the Parietex group (P = 0.001). There were three cases of seroma formation in the ULTRAPRO group and nine in the Parietex group (P = 0.02). The overall recurrence rate was 2.5%. Conclusion: It took less time to manipulate the flat mesh (ULTRAPRO) than the anatomical mesh (Parietex) in laparoscopic total extraperitoneal inguinal hernia repair, but the time difference was small. Lightweight mesh and heavyweight mesh offered similar clinical outcomes in terms of discomfort sensation and foreign body sensation during long‐term follow‐up. [ABSTRACT FROM AUTHOR]

Laparoscopic colorectal surgery has rapidly developed since the 1980s. Relative to open surgery, it offers the benefits of less invasiveness and earlier recovery. However, when a mini-laparotomy wound is needed to retrieve the specimen, the benefits of minimally invasive surgery may be compromised as a result of pain- and wound-related complications. The introduction of natural orifice transluminal endoscopic surgery ( NOTES) makes 'scarless' surgery a possibility; pain- and wound-related complications are totally abolished. However, a number of technical issues need to be overcome before this technique can be used widely. The development of natural orifice specimen extraction surgery abandons the need for a specimen-retrieval incision and helps overcome the technical hurdles of NOTES. As a bridge between true 'scarless' surgery and conventional laparoscopic surgery, hybrid procedures combining laparoscopic resection and natural orifice specimen extraction surgery currently play an important role in minimally invasive colorectal surgery. [ABSTRACT FROM AUTHOR]