Hand-assisted laparoscopic sigmoid resection for diverticular disease: 100 consecutive cases

Area of Science:

• Minimally Invasive Surgery
• Colorectal Surgery
• Surgical Oncology

Background:

• Hand-assisted laparoscopic surgery (HALS) presents advantages over conventional laparoscopy, including tactile feedback and a reduced learning curve.
• HALS aims to retain the benefits of minimal-access surgery while improving surgical experience.

Purpose of the Study:

• To evaluate the feasibility and outcomes of HALS sigmoid resection for diverticular disease.
• To assess short- and medium-term results of HALS in this patient cohort.

Main Methods:

• Prospective data collection from 100 consecutive patients undergoing HALS sigmoid resection between July 1999 and August 2004.
• Standardized telephone interviews for follow-up evaluation at a mean of 19 months post-surgery.

Main Results:

• Low intraoperative complication rate (2 major complications: splenic laceration, ureteral injury).
• High patient satisfaction (97% would choose HALS again) with a median hospital stay of 8 days.
• Postoperative complications included intraabdominal hematoma (2%), anastomotic leakage (3%), wound infection (11%), and bladder dysfunction (1%); reoperation rate was 5%.

Conclusions:

• HALS sigmoid resection for diverticular disease demonstrates a low complication rate and high patient satisfaction.
• Conversion to open surgery (midline laparotomy) can be avoided, even in complex cases.
• HALS is a feasible and effective minimally invasive surgical option for treating sigmoid diverticular disease.