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Hand assisted laparoscopic surgery versus conventional laparoscopy for colorectal surgery
Husein Moloo1, Fatima Haggar, Doug Coyle
1Division of General Surgery, The Ottawa Hospital, The Ottawa Health Research Institute, 1053 Carling Ave, Ottawa, Ontario, Canada, K1Y 4E9.
The Cochrane Database of Systematic Reviews
|October 8, 2010
Summary
Hand-assisted laparoscopic surgery for colon disease significantly reduces conversion rates compared to conventional laparoscopy. However, there were no significant differences in operative time or complications, warranting further research.
Area of Science:
- Colorectal surgery
- Minimally invasive surgery
- Surgical techniques
Background:
- Laparoscopic surgery offers perioperative benefits over open surgery for colon disease but presents technical challenges.
- Hand-assisted surgery combines open and laparoscopic approaches, potentially mitigating technical difficulties.
- This review compares laparoscopic and hand-assisted laparoscopic surgery for colorectal resections.
Purpose of the Study:
- To compare perioperative outcomes of hand-assisted laparoscopic surgery versus conventional laparoscopic surgery in adult patients undergoing colorectal resections.
Main Methods:
- Searched EMBASE, Medline, and CENTRAL databases for randomized controlled trials (RCTs) up to February 2010.
- Included RCTs comparing hand-assisted laparoscopic surgery to conventional laparoscopic colorectal resection in adults.
- Performed meta-analysis of perioperative outcomes using a random effects model.
Main Results:
- Three RCTs with 189 patients were included, covering benign, malignant, and mixed colorectal pathologies.
- Hand-assisted surgery showed a statistically significant decrease in conversion rates.
- No significant differences were observed in operative time or complication rates between the two techniques.
Conclusions:
- Hand-assisted laparoscopic surgery significantly reduces conversion rates in colorectal resections.
- Further high-quality, adequately powered trials are needed to confirm clinical significance.
- Economic analyses are recommended due to the costs associated with hand-assist devices.
