Laparoscopy for malignancy: the role of handoscopy

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopic surgery has advanced significantly, but complex procedures remain challenging due to high technical demands.
• Hand-assisted laparoscopic surgery (HALS), or handoscopy, has emerged as an adjunct to conventional laparoscopy.
• The role of HALS in managing malignancy is debated, despite its potential benefits.

Purpose of the Study:

• To evaluate the feasibility and role of hand-assisted laparoscopic surgery in oncologic procedures.
• To compare HALS with conventional laparoscopy and open surgery for managing malignancy.

Main Methods:

• Surgeons insert a hand into the body cavity via a glove-size incision while maintaining pneumoperitoneum.
• The technique facilitates tactile sensation, atraumatic retraction, blunt dissection, and vascular control.
• The hand-assisted device also protects the wound and allows intact specimen retrieval.

Main Results:

• HALS demonstrated feasibility in various oncologic procedures.
• Selected procedures showed improved recovery compared to laparotomy.
• HALS may reduce the need for conversion to open surgery.
• HALS offers a shorter learning curve and operative time, encouraging adoption of advanced laparoscopic operations.

Conclusions:

• Handoscopy provides a valuable alternative for selected complex oncologic procedures.
• It serves as an alternative to conventional laparoscopy and open surgery in malignancy management.
• HALS can potentially increase surgeon adoption of advanced laparoscopic operations.