Hand-assisted laparoscopic colectomy: a helping hand?

Adoption of laparoscopic colectomy to date has been slow because of its technical complexity and prolonged operative times. Most surgeons do not have the skill sets or colectomy volume to overcome the learning curve. The options for the future are limited. Either surgeons not skilled in laparoscopic colectomy will have to forfeit this procedure to expert laparoscopists as some have recommended or we need to find a way to simplify the procedure while maintaining the benefits of a minimally invasive approach. This article reviews the hurdles to laparoscopic colectomy and the potential benefits of the introduction of the hand to laparoscopic colectomy. In the end, the reader will have a clearer understanding of the controversy surrounding hand-assisted colectomy and why it should be expanded in its application if the majority of surgeons are to offer minimally invasive colectomy to their patients.