Background
The origins of intra-abdominal laparoscopic surgery can be traced to 1901, when Georg Kelling reported his attempts to control hemorrhage of the gastrointestinal (GI) tract in an experimental setting with “Lufttamponade” (air tamponade), while observing the process through a cystoscope placed within the peritoneal cavity.
Over the following eight decades, this technology was slow to advance in the realm of general surgery, not gaining momentum until the burgeoning of laparoscopic biliary surgery.
Over the past few decades, advances in fiber optic technology, lens modifications, and energy delivery systems have allowed the application of laparoscopic technology to fields of surgery where its use was once inconceivable. The study of laparoscopic colorectal surgery reported by Lujan et al in 2002,
more than a century after the original laparoscopic leap, lent credibility to the accuracy of this approach and clarity to the complexity involved.
Although progress has been slow, several technological milestones have allowed clinicians to apply this significantly less invasive modality to treatment of the most complex pathologic conditions. Compared with its open equivalent, laparoscopic colectomy with Hartmann-style distal remnant and end colostomy, though challenging in terms of both patient selection and surgical technique, can produce improved outcomes with less morbidity and greater patient satisfaction.
Reversal of the procedure is discussed in more detail elsewhere (see Laparoscopic Hartmann Procedure Reversal).