Hand-Assisted Laparoscopic (HAL) Multiple Segmental Colorectal Resections: Are They Feasible and Safe?

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Multiple colorectal pathologies often require complex surgical management.
• Traditional approaches for synchronous colonic pathology include extensive resection or staged procedures.
• Data on hand-assisted laparoscopic (HAL) multiple segmental colorectal resections are limited.

Purpose of the Study:

• To evaluate the short-term outcomes of synchronous hand-assisted laparoscopic (HAL) segmental colorectal resections.
• To assess the safety and feasibility of HAL for multiple synchronous colonic pathologies.

Main Methods:

• Retrospective chart review of patients undergoing HAL synchronous segmental colorectal resections between 1999 and 2014.
• Data collected included demographics, operative details, and short-term outcomes.
• Analysis of 9 patient cases performed by a colorectal surgery group.

Main Results:

• The median operative time was 210 minutes, with a median blood loss of 200 mL.
• The median return of bowel function was 2 days, and the median length of stay was 3.5 days.
• Two minor wound infections occurred; there were no deaths.

Conclusions:

• Synchronous segmental colorectal resections with anastomoses using the hand-assisted laparoscopic technique are safe.
• HAL offers a viable minimally invasive option for managing synchronous colonic pathologies.
• Conversion to open surgery or use of stomas may be advisable in complex cases.