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Related Experiment Video

Updated: Jul 13, 2026

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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Hand-assisted laparoscopic surgery (HALS) with the HandPort system: initial experience with 68 patients.

D E Litwin1, A Darzi, J Jakimowicz

  • 1Department of Surgery, University of Massachusetts Medical School, Worcester, MA 01655, USA.

Annals of Surgery
|April 18, 2000
PubMed
Summary

Hand-assisted laparoscopic surgery using the HandPort System is feasible and beneficial for complex procedures like colorectal surgery and splenectomy. This minimally invasive approach offers advantages in exploration, retraction, and hemostasis.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Laparoscopic Procedures

Background:

  • Hand-assisted laparoscopic surgery involves surgeons inserting a hand into the abdomen during pneumoperitoneum.
  • This technique aids laparoscopic instruments, proving valuable in complex surgical cases.

Purpose of the Study:

  • To assess the feasibility and benefits of a new device, the HandPort System, for hand-assisted laparoscopic surgery.
  • To evaluate its utility in various surgical procedures compared to conventional laparoscopy.

Main Methods:

  • A prospective, nonrandomized study involving 10 surgical centers.
  • Surgeons utilized the HandPort System in cases where conventional laparoscopy was deemed less advantageous.

Main Results:

  • Sixty-eight patients underwent procedures including colorectal surgery, splenectomy, donor nephrectomy, and gastric banding.
  • The mean incision size for the HandPort was 7.4 cm, with 78% of surgeons preferring their non-dominant hand.
  • Hand fatigue was reported by 20.6% of surgeons; conversion to open surgery was rare (one patient).

Conclusions:

  • Hand-assisted surgery with the HandPort System is effective for minimally invasive colorectal surgery, splenectomy, donor nephrectomy, and complex laparoscopic procedures.
  • The technique facilitates exploration, safe retraction, and immediate hemostasis.
  • Initial results compare favorably to purely laparoscopic approaches.