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Hand-Assisted Laparoscopic Surgery: A Versatile Tool for Colorectal Surgeons.
Ju Yong Cheong1, Christopher J Young1
1Department of Colorectal Surgery, Royal Prince Alfred Hospital, and University of Sydney, Discipline of Surgery, Sydney, NSW, Australia.
Annals of Coloproctology
|September 22, 2017
Summary
Hand-assisted laparoscopic surgery (HALS) is a versatile minimally invasive technique for colorectal resection. This study found HALS is independent of patient BMI and previous surgeries, demonstrating its broad applicability.
Area of Science:
- Minimally Invasive Surgery
- Colorectal Surgery
- Surgical Oncology
Background:
- Hand-assisted laparoscopic surgery (HALS) combines laparoscopic benefits with enhanced tactile control.
- Obesity is linked to higher conversion rates in multiport laparoscopic surgery, but data for HALS is limited.
Purpose of the Study:
- To evaluate the versatility of Hand-assisted laparoscopic surgery (HALS) across diverse clinical scenarios.
- To assess the impact of patient factors like BMI and previous surgeries on HALS outcomes for colorectal resection.
Main Methods:
- Prospective data collection of HALS procedures at two tertiary centers.
- Retrospective analysis of variables including BMI, prior surgeries, pathology, and conversion rates to open laparotomy.
Main Results:
- 121 HALS colorectal resections were analyzed; 50.2% of patients were overweight or obese.
- Conversion to laparotomy occurred in 7 patients, but obesity or adhesions were not causative factors.
- HALS facilitated resection of involved adjacent organs (bladder, uterus, ureter) and was not impacted by adhesions.
Conclusions:
- Hand-assisted laparoscopic surgery (HALS) is a versatile minimally invasive approach for colorectal resection.
- HALS outcomes are independent of patient body mass index (BMI).
- The technique demonstrates efficacy even in patients with prior abdominal surgeries and adhesions.