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Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Hand-assisted laparoscopic versus open right colectomy: a randomized controlled trial
Chi Chiu Chung1, Dennis Chung Kei Ng, Wilson Wen Chieng Tsang
1Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR, China. ccchung827@yahoo.com.hk
Annals of Surgery
|October 31, 2007
Summary
Hand-assisted laparoscopic colectomy (HALC) offers short-term benefits for right-sided colon cancer patients, including less pain and shorter hospital stays. While operative time is slightly longer, HALC is a viable alternative to open colectomy (OC) with similar long-term survival rates.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Colorectal Surgery
Background:
- Laparoscopic colectomy presents challenges in tactile feedback and depth perception.
- Hand-access devices aim to mitigate these limitations in laparoscopic surgery.
- Open colectomy (OC) is a traditional approach for right-sided colonic cancer.
Purpose of the Study:
- To compare the efficacy and outcomes of hand-assisted laparoscopic colectomy (HALC) versus open colectomy (OC).
- To evaluate HALC as a management option for right-sided colonic cancer.
Main Methods:
- A randomized controlled trial involving adult patients with nonmetastatic right-sided colonic cancer.
- Patients were randomized to undergo either HALC or OC.
- Outcomes assessed included operative time, blood loss, pain, hospital stay, complications, recurrence, and survival.
Main Results:
- HALC showed significantly less blood loss (35 mL vs. 50 mL) and shorter hospital stays (7 vs. 9 days).
- Patients undergoing HALC reported less pain and required less analgesia.
- Operative time was longer for HALC (110 min vs. 97.5 min), but disease recurrence and 5-year survival rates were similar between groups (83% vs. 74%).
Conclusions:
- Hand-assisted laparoscopic colectomy (HALC) provides short-term benefits comparable to pure laparoscopic surgery.
- HALC is an effective alternative for right-sided colonic cancer, with acceptable operative times.
- The technique offers advantages in pain management and recovery, with oncological outcomes similar to open colectomy.
