Four major contraindications for laparoscopic surgery for colon cancer

Although laparoscopic surgery for colon cancer has the advantages of clear surgical field, less bleeding, less trauma, and less pain compared to open surgery, not all patients are suitable for this surgical approach.

Contraindications to laparoscopic colon cancer surgery include:

1. Diseases that can tolerate prolonged pneumoperitoneum (such as severe cardiopulmonary diseases and infections)

Laparoscopic colon surgery often involves a wide range of freeing, and multiple changes of body position are often required during the operation to complete the freeing of the resected intestinal segment. Excessive adjustment of body position, coupled with continuous pneumoperitoneum pressure, increases the resistance of vena cava return, lifts the diaphragm, and limits cardiopulmonary activity, leading to hemodynamic changes.

2. Conditions that make it difficult to control bleeding (such as portal hypertension, coagulation disorders, etc.)

Coagulation disorders may lead to uncontrollable bleeding during both open and laparoscopic surgery. Laparoscopic surgery is particularly sensitive to bleeding, and even a small amount of bleeding can reduce the brightness of the visual field, make the anatomical layers unclear, and blur the surgical field. Therefore, common coagulation disorders, such as portal hypertension, should be treated in a timely manner and corrected before surgery as much as possible to reduce surgical risks.

3. Situations with limited technology (morbid obesity, extensive intra-abdominal adhesions, combined intestinal obstruction and pregnancy, etc.)

Many contraindications that limit laparoscopic technology are relative concepts. It is difficult to have an exact definition of pathological obesity. Obesity is included in the contraindications because the laparoscopic surgical space exposure is limited in obese patients, the anatomical levels are unclear, some important structural landmarks are difficult to identify, and the operator's skills and professional analysis and comprehensive ability are required to be high.

4. The tumor invades adjacent tissues and organs such as the ureter, bladder, and small intestine

In the advanced stage, the tumor has invaded adjacent organs, such as the ureter, bladder, small intestine, and duodenum. Surgery has lost its curative effect. However, palliative resection of the tumor should be attempted to reduce the tumor's consumption of the body and prevent bleeding and obstruction. Surgery is very difficult because it involves the removal and even reconstruction of adjacent organs. It is generally not recommended to be performed under laparoscopy.