Laparoscopic Surgery for Crohnʼs Disease? A Conditional Yes

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Abstract
Beginning with the introduction of laparoscopic cholecystectomy a little more than a decade ago, minimally invasive techniques have revolutionized abdominal surgery. Since that time, it has been established that virtually any abdominal operation can be performed through the laparoscope. For the most part, the introduction of these procedures has been driven by technologic innovation and patient demand in the absence of randomized trials demonstrating their benefits. For some procedures, such as laparoscopic cholecystectomy and Nissen fundoplication, the advantages are obvious. In the case of others, such as splenectomy and probably herniorrhaphy, the benefits are less marked but still demonstrable. Finally, it appears that some complex operations, such as laparoscopic pancreatectomy and esophagectomy, while representing interesting technical exercises, are probably of no real benefit and may even be associated with increased morbidity and/or cost. In the case of laparoscopic surgery for Crohn's disease (CD), the verdict is not yet in, although an increasing amount of evidence would suggest that such an approach may be appropriate in selected patients with specific indications for operation.

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