Barry W Feig

Chapter Overview 58

Introduction 59

Palliation 59

Staging 60

Therapeutic Procedures 62

Tumor Implantation 63

Conclusion 64

Key Practice Points 65

Suggested Readings 65

Chapter Overview

The introduction of laparoscopy into the armamentarium of the general surgeon in the late 1980s resulted in a revolution of new technology and procedures. Despite this meteoric application in general surgery, there has been only a slow and cautious application of laparoscopic procedures in surgical oncology. This has been due in large part to concerns about peritoneal dissemination and port-site implantation raised by a number of reports that appeared early in the process of evaluating laparoscopic procedures in patients with intra-abdominal malignancies. At M. D. Anderson Cancer Center, we began evaluating the role of laparoscopy in surgical oncology in the early 1990s. Since that time, we have used laparoscopy in a wide variety of disease processes. Our use of laparoscopy in gastrointestinal malignancies has evolved over the last 10 years; this chapter will present some of the original applications and their evolution to our present surgical practice. Additionally, the available data as they pertain to the controversy regarding tumor dissemination and port-site implantation will be presented.

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