I. What is colorectum? The colon includes two parts: the colon and the rectum. 40% of tumors are born in the rectum. The colon includes cecum, ascending colon, transverse colon, descending colon and sigmoid colon. What are the early symptoms of colorectal cancer? 1.slow change of defecation habit (it can be weeks or months); 2.diarrhea and bloating; 3.weight loss; 4.anemia; 5.blood in stool. III. History of laparoscopic surgery The history of laparoscopic surgery is not very long. It was first used in general surgery to do gallbladder removal, and then gradually other resections were tried again. The first laparoscopic cholecystectomy in the world was performed in 1987, when the operation took 6 hours, but now it can be done in 10-15 minutes. In the past, this procedure was only used in general surgery to treat benign diseases, and only since 1995 has research been gradually started to treat malignant tumors, such as endometrial cancer, esophageal cancer, stomach cancer, and intestinal cancer. The earliest surgery for bowel cancer was performed in 1991 in the United States, and Ruijin Hospital started to try to treat it in 1993, but the whole development is relatively slow, and now with the gradual improvement of technology, this technology has gradually become mature. Difference between laparoscopic surgery and traditional surgery for colorectal cancer If a patient is diagnosed with colorectal cancer, the traditional treatment method requires opening a 20-25 cm incision in the abdomen, then resecting the intestinal segment, removing the intestinal segment, tumor and lymphatic drainage, and then connecting the intestine, due to the large incision, the patient’s trauma is relatively large, and the postoperative recovery is The postoperative recovery is relatively slow. The difference is that laparoscopic surgery does not require opening a large incision, but only 4-5 small holes (about 0.5~1.0 cm in diameter), and the procedure is performed under television monitoring, using an electric knife or ultrasonic knife (Aishikang) to remove the intestinal segment and the surrounding lymphatic drains. After adequate freeing, the entire intestinal segment and tumor should be removed through an appendix-sized incision (about 6 cm long) in the abdominal wall in accordance with the principle of radical treatment by applying a lumpectomy anastomosis (Endo-GI of Johnson & Johnson, USA) to sever the root of the tumor supplying vessels (rectal cancer should also be separated from the distal intestinal canal of the tumor), and then in vitro The resection is performed outside the body, and the intestinal segment is anastomosed by a very advanced automatic anastomosis clutch (such as the CDH double anastomosis or TLC linear anastomosis of Johnson & Johnson, USA). V. Superiority of laparoscopic surgery for colorectal cancer Compared with traditional open surgery, laparoscopic surgery for colorectal cancer is less painful, faster recovery, less complications, shorter hospital stay and satisfactory results. Its advantages are mainly reflected in stage III tumor patients, low tumor recurrence rate after surgery and prolonged overall survival. The advantages also include: 1. the image is very clear. 2. there is magnification. 3. the parts that cannot be seen by eyes can be seen, such as rectal surgery for pelvic and presacral area surgery can be seen clearly. Can laparoscopic resection of tumors be very complete? The so-called complete means that not only the tumor should be removed but also the lymphatic system that can be metastasized should be cut off together. Laparoscopic surgery is very easy to remove the lymphatic system, so from this point of view it should be very thorough. In addition, since the surgery is performed with instruments and not with the hands, the possibility of spread is reduced. In general, laparoscopic surgery can do everything that conventional surgery can do and even better. 7. Can all colorectal tumors be treated by laparoscopic surgery? In principle, all colorectal tumors can be treated by laparoscopic surgery, but in some cases it is more difficult to operate, such as very large tumors (7 cm or more), which may require relatively large incisions, or patients with intestinal obstruction, repeated surgical history, advanced stage or strong adhesions of surrounding tissues, pathological obesity (even up to 200 kg), etc. Eight, the practical application and development prospects of laparoscopic technology in colorectal diseases Currently, the use of laparoscopic technology can treat multiple colon polyps, colorectal cancer, colonic redundancy, etc. For example, laparoscopic-assisted combined abdominal perineal resection (Miles procedure) and anterior rectal resection (Dixon procedure). In addition, hand-assisted laparoscopic right hemicolectomy or left hemicolectomy can be performed with a laparoscopic hand aid (e.g., Blue Butterfly laparoscopic hand aid from Johnson & Johnson, USA). Laparoscopic techniques are challenging traditional complex and difficult procedures. Satisfactory results have been reported for laparoscopic-assisted total rectal mesorectal excision (TME) and J-shaped colonic pouch reconstruction for low- to mid-level rectal cancer. Laparoscopic-assisted colorectal resection is expected to become the standard surgical approach for colorectal cancer.