What Is Laparoscopic Surgery?

Laparoscopic or “minimally invasive” surgery is a specialized surgical technique. It was first introduced in gallbladder and gynecological operations and has since evolved. Over the last decade, it has become widely used in intestinal and colorectal surgery.
In traditional open surgery, the surgeon accesses the abdominal cavity through a long incision. In laparoscopic surgery, several small incisions (0.5–1 cm) called ports are made. Special tube-like instruments called trocars are inserted through these ports.
During the procedure, a high-definition optical camera (laparoscope) and specialized surgical instruments are introduced through these openings.
The abdomen is inflated with carbon dioxide gas to create space for visualization and manipulation. The laparoscope transmits detailed images of the abdominal cavity to high-resolution video monitors around the operating table.
This allows the surgeon to perform complex operations using small incisions with real-time, magnified visualization — achieving the same results as traditional open surgery.

Advantages of Laparoscopic Surgery

Compared to open surgery, patients experience:

  • Less postoperative pain

  • Faster recovery and mobilization

  • Earlier return of bowel function

  • Significantly lower rates of incisional hernia

Which Surgeries Can Be Performed Laparoscopically?

Most intestinal diseases can be treated using laparoscopic (closed) surgery. These include:

  • Colon and rectal cancers

  • Diverticulitis

  • Rectal prolapse

  • Inflammatory bowel diseases (Ulcerative colitis, Crohn’s disease)

Especially in colon and rectal cancers, laparoscopic surgery is now a standard approach performed by trained and experienced surgeons worldwide, including in Turkey.

How Safe Is the Laparoscopic Method?

Laparoscopic surgery is as safe as open surgery.
At the start of the procedure, a trocar is placed below the navel, and the laparoscope (camera) is inserted. The surgeon inspects the abdominal cavity to determine whether laparoscopic surgery is suitable.
If extensive inflammation, severe adhesions between the intestines, or other technical obstacles are encountered, the surgeon may safely convert to open surgery.

Complications such as anesthesia-related issues, bleeding, or infection may occur in both open and laparoscopic operations — not because of the technique itself, but due to the nature of the surgery.
However, with laparoscopy, wound complications and incisional hernias are reported much less frequently.

While laparoscopic procedures utilize advanced technology, their success primarily depends on the surgeon’s skill, knowledge of anatomy, and mastery of the disease and procedure.
Technology enhances surgical precision, but the main goal remains effective treatment — thus, open surgery may still be the safer choice in specific conditions.

Open Surgery for Colon and Rectal Procedures

In open surgery, a 15–20 cm incision is usually made along the midline of the abdomen to access internal organs and place surgical instruments.
This large incision can lead to:

  • Significant postoperative pain

  • Delayed bowel function

  • Longer hospital stays

  • Slower return to daily activities

  • Hernia formation at the incision site in up to 30% of cases

In cancer surgery, the golden rule is to remove the tumor en bloc, including all surrounding affected tissues.
In cases where the tumor has invaded adjacent organs or when its size matches the incision length, open surgery may be preferred for safety and complete removal.

What Is Robotic Surgery?

Robotic surgery is a modern branch of minimally invasive surgery.
It is similar in principle to laparoscopy — instruments are inserted through small incisions using trocars.
The difference is that the instruments are controlled by a robotic system, not by hand.

The surgeon operates from a console, viewing a three-dimensional high-definition image of the surgical field.
A complex computer system translates the surgeon’s hand movements into precise robotic instrument motions.

This technology allows for superior dexterity, precision, and visualization, especially in narrow and deep spaces such as the lower rectum near the anus, where working areas are limited.