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The American Society of Colon and Rectal Surgeons (ASCRS) and the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) recognize that laparoscopic proctectomy may be an alternative to traditional resection of benign disease involving the rectum. The absence of five-year survival data makes it premature to endorse laparoscopic proctectomy for curable cancer. Laparoscopic proctectomy must follow traditional surgical principles and standards including adequate mesorectal excision and the achievement of appropriate clear margins.

It is only appropriate to perform laparoscopic proctectomy for curable cancer in an environment where the outcomes can be meaningfully evaluated until laparoscopic approaches have been shown to be as efficacious as open approaches. The ASCRS and SAGES encourage the development of properly designed studies to evaluate the safety, efficacy, and benefits of this approach.

The ASCRS and SAGES consider laparoscopic proctectomy to be within the expertise of trained surgeons who focus on the treatment of rectal cancer. Development of this expertise should include observation of procedures, laboratory experience and graduated clinical responsibility as mentioned in published guidelines1,2.

1. Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer. SAGES publication #32
2. ASCRS Practice Parameters for the Management of Rectal Cancer (Revised). Dis Colon Rectum 2005;48:411-423.