Laparoscopic surgery in the treatment of Crohn's disease

Crohn's disease (CD) is one of the most challenging arenas of intestinal surgery. Many of its pathologic features intense inflammation, a thickened mesentery, enteric fistulae, and skip areas of intestinal involvement have justifiably deterred surgeons from considering a laparoscopic approach. Nonetheless, most patients who have CD understand that they have a high (70%-90%) probability of needing surgery at some point; thus they are extremely motivated to undergo an operation that could involve minimal scarring and a faster recovery. This article presents the current evidence for the use of laparoscopic techniques in the surgical therapy of Crohn's disease of the small and large intestine. Indications and some key aspects of our current laparoscopic techniques to manage Crohn's disease are also discussed.