#### Summary points The uptake of laparoscopic colorectal surgery is increasing annually. Colon resection using this approach was first reported in 1991, but hospital episode statistics (HES) data show that 22% of colon resections in the United Kingdom in were performed in this manner by 2008-9.1 2 The laparoscopic approach minimises surgical trauma and allows faster recovery from surgery, and it has been evaluated for other operations, such as cholecystectomy. Early reports of the outcomes of laparoscopic colorectal surgery comprised mostly non-malignant cases, but more recently laparoscopic surgery has become widely used for colorectal cancer. Updated guidance (2010) from the UK National Institute for Health and Clinical Excellence recommends that all patients deemed suitable must be offered laparoscopic surgery even if this means onward referral to a suitably qualified surgeon.3 We review the effectiveness of laparoscopic colorectal surgery compared with open surgery and the potential adverse effects. #### Sources and selection criteria We searched the Cochrane databases using the terms laparoscopic, colorectal surgery, colorectal cancer, diverticular disease, Crohn’s disease, and ulcerative colitis to identify observational studies, case series, and randomised trials. The rationale for using laparoscopic surgery is that it can help minimise the trauma of access, reduce pain, and accelerate postoperative return of bowel function and general mobility. All these factors may shorten hospital stay. Other potential benefits include reduced formation of adhesions and lower rates of incisional hernia. A trocar, which acts as a conduit for the camera and operating instruments, is …