Laparoscopy and Endoscopy

Endoscopy and laparoscopy are integral to the current practice of colon and rectal surgery and both techniques have benefited from advances in technology. This issue of Clinics in Colon and Rectal Surgery focuses on various aspects of laparoscopy and endoscopy. The authors are experienced and have varied backgrounds and interests. Their contributions provide insights in a clear and understandable format.

Electronic medical records are rapidly becoming a major part of our care documentation. This issue starts with a primer on endoscopic electronic medical records by Drs. Atreja, Rizk, and Gurland from the Cleveland Clinic Foundation. Next, I have summarized our current understanding of bowel preparations for colonoscopy. Although a clean colon is essential for a safe and accurate examination, many patients find their preparation the most challenging portion of the test.

To improve patient comfort, sedation and analgesia are routinely used in colonoscopy. Drs. Wiggins, Khan, and Winstead from the Ochsner Clinic Foundation Gastroenterology Department describe the current medications available and the patient monitoring necessary to maintain safety. Colonoscopy has well-recognized limitations. Chromoendoscopy and narrow band imaging have been evaluated to improve lesion recognition. Drs. Nass and Connolly discuss the technology and its current role in colonoscopy.

Next, two major colonic problems, hemorrhage and malignant obstruction, are explored. Dr. Whitlow, from the Ochsner Clinic, summarizes endoscopic treatment of lower gastrointestinal bleeding, and I review endoscopic stents and dilatation.

Finally, two aspects of laparoscopy are discussed. Drs. Shin and Rafferty, from the University of Cincinnati, cover benign disease and Drs. Nandakumar and Fleshman, from St. Louis, cover laparoscopy for colon and rectal cancer.

Editing this issue has been a gratifying experience as it covers important aspects of our colorectal practice. I sincerely thank the authors for taking the time from their demanding practices and even more important limited family time to contribute to this issue.