[Application and indication choice of hand-assisted laparoscopic operation in gastrointestinal surgery]

Despite gaining wider popularity in the management of both benign and malignant gastrointestinal diseases over the past decade, traditional laparoscopic surgery remains to be associated with several distinct disadvantages, including longer operative time, longer learning curve, technical difficulty in obese patients and complicated cases. As a hybrid technique between open surgery and traditional laparoscopic surgery, hand-assisted laparoscopic surgery (HALS) brings back tactile feeling and hand-to-eye coordination to surgeons. It allows surgeons to perform more complicated gastrointestinal surgery, while retaining the merits of traditional laparoscopic surgery. It also improves operative time and learning curve. The main disadvantages of HALS seem to be the hindering effect and fatigue of the inserted hand. The exact role of HALS in gastrointestinal surgery has not been well defined due to lack of substantial evidences from clinical trials.