OBJECTIVES: The objective of this study is to examine the trends in utilization of laparoscopy in the treatments of colorectal cancer, inflammatory bowel disease, diverticular disease and other pathologies.METHODS: We performed a retrospective analysis using the Healthcare Cost and Utilization Project Nation-wide Inpatient Sample from 2002 and 2005 identifying patients who underwent elective laparoscopic or open colectomy (N = 149,304). Patients were then divided into four categories based on pathology: cancer (N = 63,279), inflammatory bowel disease (IBD) (N = 5,325), diverticulitis (N = 27,412) and other (N = 53,288). Weighted univariate analyses were used to evaluate statistical significance in patient characteristics between laparoscopic and open treatment for these pathologies.RESULTS: Trends toward higher utilization of laparoscopic treatment of all pathologies were seen at urban teaching hospitals, and regionally in the northeastern and western geographical location. No other trends were noticed among patients with IBD. Patients who had pathology other than IBD (cancer, diverticulitis and other) were more likely to have laparoscopic surgery if they had private insurance or a higher than average income. Interestingly, younger age and race (Hispanics, other) predict laparoscopic treatment only for diverticulitis.CONCLUSIONS: Laparoscopic techniques have clear benefits in morbidity and outcome over traditional open technique in both benign inflammatory diseases and cancer. There are disparities amongst patients who receive laparoscopic colorectal surgery which should be further investigated in an attempt to improve outcomes of all patients.