Die laparoskopischen kolorektalen Operationen setzen neben der Beherrschung der konventionellen Dickdarmchirurgie eine umfangreiche Erfahrung in der laparoskopischen Operationstechnik voraus; dies gilt für das gesamte Operationsteam. In der vorliegenden Arbeit wird über 45 laparoskopische Kontinuitätsresektionen am Sigma und oberen Rektum berichtet. Zur Operation gelangten 34 Patienten mit gutartigen und 11 Patienten mit malignen Erkrankungen des Rektums und des Sigmas. In einem Fall war eine Konversion zum offenen Vorgehen erforderlich. Bei 10 Patienten traten postoperativ Komplikationen auf (2 Nachblutungen, 1 Hämatom im Douglas, 1 Anastomoseninsuffizienz und 6 Drainagekanalinfektionen), in einem Fall mit letalem Ausgang.Die Vorbereitung der Patienten, das operative Vorgehen und die Ergebnisse werden dargestellt und diskutiert.

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