***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: PURPOSE In carefully matched patients , the length of hospital stay after  laparoscopic colectomy  is shorter than after open surgery . Higher operating room costs for laparoscopic surgery are offset by lower costs for hospitalization because of less utilization of pharmacy , laboratory , and nursing services . Clinical outcome is comparable . We examined the effect of the surgical approach for colectomy ( open vs. laparoscopic ) regarding the reasons for disease-related group assignment to disease-related group 148 , and institutional cost under Part A of the U.S. Medicare system . METHODS Colectomy patients were assigned to either disease-related group 148 ( colorectal resection with complications ) or disease-related group 149 ( colorectal resection without complications ) with significant institutional reimbursement implication s ( disease-related group 149 , $ 8,310 ; disease-related group 148 , $ 20,291 ) . A total of 100 consecutive disease-related group 148 patients undergoing laparoscopic colectomy from July 2000 to September 2002 were identified from a prospect i ve data base and case-matched with 100 patients undergoing open colectomy .  Patients were matched for gender , age , operative procedure , and pathology . A certified coder determined the reason(s ) for disease-related group 148 assignment , which were grouped into : preoperative comorbidity , a combination of preoperative comorbidity/postoperative complications , or postoperative complications alone . RESULTS Significantly more lapararoscopy patients were assigned to disease-related group 148 solely because of preoperative comorbidities ( 62 percent vs. 21 percent ; P < 0.0001 ) . Significantly more patients in the open surgery group were classified as disease-related group 148 solely because of postoperative complications ( 22 percent vs. 42 percent ; P < 0.0001 ) . An additional group of patients were assigned to the disease-related group 148 category based on a combination of preoperative and postoperative diagnoses ( 16 percent vs. 37 percent ) . The mean direct hospital costs were significantly less for laparoscopy patients ( $ 3971 vs. $ 5997 ; P = 0.0095 ) . Increased cost to Part A of Medicare for 20 open surgery patients who “ migrated ” to disease-related group 148 because of postoperative complications was $ 239,620 . CONCLUSIONS Our data are the first to demonstrate that disease related group assignment can change solely because of a differential rate of postoperative complications for two competing operative techniques . This change occurred at twice the rate for open colectomy and result ed in significantly increased cost to the insurer under a prospect i ve payment program . The savings to the institution coupled with the shortened length of stay offset the potential loss in revenue to the institution Abstract Background : The role and feasibility of laparoscopic assisted colectomy ( LAC )  in both benign and malignant disease of the colon are not clear . We have review ed our series in an effort to further delineate whether or not LAC is appropriate in the treatment of colonic disease . Methods : This is a retrospective view of a personal series focusing on feasibility , cure of malignant disease , and length of stay ( LOS ) . Results : One hundred and two LACs were completed out of 104 attempts ( 98 % ) . There were no wound or trocar implants in the Dukes A , B and C patients . Lymph node retrieval was similar in the laparoscopic and open historical controls . The LOS was 5.9 days in the LAC group as compared with 11 days in the open group . There was a 4.8 % major morbidity rate and a 1 % mortality rate in this series . Conclusions : LAC is technically feasible in a high percentage of patients . While a definite statement regarding its use in malignant disease can not be ascertained from this review , the preliminary results are encouraging . A r and omized trial comparing open and LAC is warranted Robotic laparoscopic surgery is postulated to result in better surgical results by allowing improved instrument manipulation and three-dimensional vision . The authors ’ experience performing robot-assisted laparoscopic colorectal surgery is reported . METHOD : St and ard laparoscopic procedures with robot-assisted laparoscopic colon mobilization and vascular ligation were performed . Data relating to the operative procedure , hospital stay , and direct costs were collected . Results were compared with age , gender , and procedure case-matched controls taken from a prospect i ve laparoscopic colorectal surgery data base . RESULTS : Six robot-assisted laparoscopic surgeries ( 2 right hemicolectomies , 3 sigmoid colectomies , and 1 Wells rectopexy ) were performed between December 2001 and June 2002 . There was no associated morbidity . Operative time was increased from a median time of 108 minutes for st and ard laparoscopic colorectal surgery to 165 minutes for robot-assisted laparoscopic surgeries ( P = 0.0313 ; Wilcoxon matched-pairs signed-rank test for non-parametric data ) . This was primarily a result of the time required for robot set-up . Blood loss , length of stay , and hospital cost were not significantly different between groups . Additional direct equipment costs for RAC cases included robotic laparoscopic instruments and sterile drapes ( approximately US $ 350 per case ) , without including acquisition and maintenance costs for the robot . CONCLUSION : Robot-assisted laparoscopic colectomy is a feasible and safe procedure . Although three-dimensional vision and dexterity are facilitated , operative time is increased and the overall additional expense of robotics is of concern . Robot-assisted laparoscopic colectomy requires further evaluation to establish clinical and financial benefits before introduction to routine practice . Such techniques may , in the future , facilitate complex laparoscopic techniques BACKGROUND Minimally invasive , laparoscopically assisted surgery was first considered in 1990 for patients undergoing colectomy for cancer . Concern that this approach would compromise survival by failing to achieve a proper oncologic resection or adequate staging or by altering patterns of recurrence ( based on frequent reports of tumor recurrences within surgical wounds ) prompted a controlled trial evaluation . METHODS We conducted a noninferiority trial at 48 institutions and r and omly assigned 872 patients with adenocarcinoma of the colon to undergo open or laparoscopically assisted colectomy performed by credentialed surgeons . The median follow-up was 4.4 years . The primary end point was the time to tumor recurrence . RESULTS At three years , the rates of recurrence were similar in the two groups--16 percent among patients in the group that underwent laparoscopically assisted surgery and 18 percent among patients in the open-colectomy group ( two-sided P=0.32 ; hazard ratio for recurrence , 0.86 ; 95 percent confidence interval , 0.63 to 1.17 ) . Recurrence rates in surgical wounds were less than 1 percent in both groups ( P=0.50 ) . The overall survival rate at three years was also very similar in the two groups ( 86 percent in the laparoscopic-surgery group and 85 percent in the open-colectomy group ; P=0.51 ; hazard ratio for death in the laparoscopic-surgery group , 0.91 ; 95 percent confidence interval , 0.68 to 1.21 ) , with no significant difference between groups in the time to recurrence or overall survival for patients with any stage of cancer . Perioperative recovery was faster in the laparoscopic-surgery group than in the open-colectomy group , as reflected by a shorter median hospital stay ( five days vs. six days , P<0.001 ) and briefer use of parenteral narcotics ( three days vs. four days , P<0.001 ) and oral analgesics ( one day vs. two days , P=0.02 ) . The rates of intraoperative complications , 30-day postoperative mortality , complications at discharge and 60 days , hospital readmission , and reoperation were very similar between groups . CONCLUSIONS In this multi-institutional study , the rates of recurrent cancer were similar after laparoscopically assisted colectomy and open colectomy , suggesting that the laparoscopic approach is an acceptable alternative to open surgery for colon cancer BACKGROUND The appropriateness of laparoscopic colon resection ( LCR ) as treatment for malignancy has been question ed . METHODS From 1992 to 1997 , 91 patients were entered into a prospect i ve study of LCR for cancer . Clinical , pathologic , and economic parameters of LCR were compared in a cohort of patients matched for age , tumor stage , and type of colectomy who underwent open colon resection ( OCR ) during the same time period . RESULTS With a median follow-up of 26 months , there were no significant differences in survival rate for patients in the LCR , converted colon resection , and OCR groups . There were no port-site recurrences and the number of lymph nodes harvested was similar among the procedures . Hospital stay was significantly shorter if laparoscopic resection was successful . Total hospital costs were similar for LCR and OCR ; however , the costs were significantly higher for converted colon resection . CONCLUSIONS LCR is a sound oncologic procedure that can be performed with costs similar to OCR Objective The authors studied the results of laparoscopic colectomies  performed by a surgical team on 80 consecutive patients and compared these results with st and ard open colectomies . Methods Eighty consecutive laparoscopic-assisted colectomies were performed by Norfolk Surgical Group in a 14-month period and compared to 53 patients who had a conventional open colectomies .  Analysis included indications for surgery , types of procedure , complications , incidence and causes for conversion , length of procedure , duration of postoperative ileus , hospital stay , operating room and total hospital charges , and examination of the pathologic specimens . Results Many different types of colectomies were performed successfully and safely for a variety of surgical indications . The conversion rate was 22.5 % , which decreased to 15 % in the second half of the series . Complications in patients who underwent laparoscopic operations were not severe in number or type . The length of the operative procedure , operating room charge , and the total hospital charge were greater for patients undergoing laparoscopic-assisted colectomies . Patients who underwent laparoscopic operations had a shorter period of postoperative ileus and less pain , resumed a regular diet sooner , and were discharged from the hospital sooner than patients who underwent open colectomies . There was no significant difference in the pathology specimens obtained by laparoscopic-assisted colectomies compared with conventional open colectomies for length of specimen , surgical margins , and number of lymph nodes retrieved . Conclusions This study indicated that laparoscopic techniques can be applied safely and effectively to a broad range of colonic operations . Laparoscopic-assisted colectomies take longer to perform and are more costly , but are associated with less paralytic ileus , less pain , and reduced hospital stay .  Laparoscopic colectomies for the treatment of malignancy are achievable technically , but will require careful long-term study BACKGROUND The safety and short-term benefits of laparoscopic colectomy for cancer remain debatable . The multicentre COLOR ( COlon cancer Laparoscopic or Open Resection ) trial was done to assess the safety and benefit of laparoscopic resection compared with open resection for curative treatment of patients with cancer of the right or left colon . METHODS 627 patients were r and omly assigned to laparoscopic surgery and 621 patients to open surgery .  The primary endpoint was cancer-free survival 3 years after surgery . Secondary outcomes were short-term morbidity and mortality , number of positive resection margins , local recurrence , port-site or wound-site recurrence , metastasis , overall survival , and blood loss during surgery . Analysis was by intention to treat . Here , clinical characteristics , operative findings , and postoperative outcome are reported . FINDINGS Patients assigned laparoscopic resection had less blood loss compared with those assigned open resection ( median 100 mL [ range 0 - 2700 ] vs 175 mL [ 0 - 2000 ] , p<0.0001 ) , although laparoscopic surgery lasted 30 min longer than did open surgery ( p<0.0001 ) . Conversion to open surgery was needed for 91 ( 17 % ) patients undergoing the laparoscopic procedure . Radicality of resection as assessed by number of removed lymph nodes and length of resected oral and aboral bowel did not differ between groups . Laparoscopic colectomy was associated with earlier recovery of bowel function ( p<0.0001 ) , need for fewer analgesics , and with a shorter hospital stay ( p<0.0001 ) compared with open colectomy .  Morbidity and mortality 28 days after colectomy did not differ between groups . INTERPRETATION Laparoscopic surgery can be used for safe and radical resection of cancer in the right , left , and sigmoid colon The objectives of this study were to compare both subjective clinical outcomes and the objective stress response of laparoscopic and open abdominal rectopexy in patients with full‐thickness rectal prolapse .  Abdominal rectopexy for patients with rectal prolapse is well suited for a laparoscopic approach as no resection or anastomosis is necessary PURPOSE : This study was undertaken to compare morbidity , mortality , and pathology after  laparoscopically assisted right hemicolectomy ( LARHC ) or open right hemicolectomy 
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Conclusions Operating room costs are greater for laparoscopic colorectal surgery than open surgery .
Total hospital costs are similar .
There may be societal benefits associated with lower indirect costs  for laparoscopic colorectal surgery .