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Hand-assisted laparoscopic surgery (HALS): a report of 150 procedures
S Maartense1, W A Bemelman, A Gerritsen van der Hoop
1Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
Surgical Endoscopy
|January 22, 2004
Summary
Hand-assisted laparoscopic surgery (HALS) is safe and effective for donor nephrectomies and colectomies. However, its benefits are limited for splenectomies and segmental bowel resections, with some patients experiencing complications.
Area of Science:
- Minimally Invasive Surgery
- Surgical Outcomes
- Laparoscopic Techniques
Background:
- Evaluating long-term morbidity of hand-assisted laparoscopic surgery (HALS).
- Assessing surgical complications and incisional hernia development post-HALS.
Purpose of the Study:
- To determine the safety and feasibility of HALS across diverse surgical indications.
- To analyze postsurgical complications and incisional hernia rates associated with HALS.
Main Methods:
- Prospective evaluation of HALS procedures from 1995 to 2002.
- Monitoring primary outcomes: postsurgical complications and incisional hernias.
- Analysis of various procedures including splenectomies, donor nephrectomies, and bowel resections.
Main Results:
- HALS demonstrated feasibility for splenectomies, donor nephrectomies, bowel resections, and colectomies.
- Minor complication rates varied by procedure, with emergency colectomies showing the highest (33%).
- Incisional hernias occurred in 4% of patients, exclusively after Küstner incision wound complications.
Conclusions:
- HALS is a fast, safe, and feasible approach for various procedures, particularly hand-assisted laparoscopic donor nephrectomies and colectomies.
- Limited advantages of HALS were observed in splenectomy and segmental bowel resection.
- The study highlights the importance of incision type in HALS regarding hernia development.