What should we intend for minimally invasive treatment of colorectal cancer?

•We reviewed RCTs on laparoscopic treatment of colorectal carcinoma analyzing main limits.•We analyzed new technical possibilities in laparoscopic treatment of colon cancer.•We analyzed new technical possibilities in laparoscopic treatment of rectal cancer.•We encouraged the adoption of perioperative programs in order to optimize postoperative management.

Non-inferiority of laparoscopic treatment of colorectal cancer (CRC) has been demonstrated in randomized controlled trials although operative and perioperative management varies widely among centers. Literature data in English language published up to April 15, 2014 were analyzed in order to give an up to date analysis that would highlights the key aspects of a modern and factual minimally invasive treatment of CRC. Laparoscopic resection is the first choice treatment of colon cancer. Laparoscopic resection of rectal cancer should be considered an investigational procedure to be performed in high volume centers with special interest in laparoscopy and colorectal surgery. Less invasive approaches should be taken into account with the aim of reducing surgical stress. The adoption of ERAS programs has demonstrated to optimize short-term results. Future research should be directed to prove possible long-term advantages, in terms of overall and disease-free survival, of minimally invasive treatment of CRC.