Hand-assisted Laparoscopy: Expensive but Considerable Step Between Laparoscopic and Open Colectomy.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Outcomes and Cost Analysis

Background:

• Laparoscopic colectomy techniques, including hand-assisted laparoscopic colectomy (HALC) and laparoscopic-assisted colectomy (LAC), offer comparable short-term outcomes.
• Limited data exist on the comparative costs associated with HALC and LAC.

Purpose of the Study:

• To compare the short-term outcomes and costs of hand-assisted laparoscopic colectomy (HALC) versus laparoscopic-assisted colectomy (LAC).

Main Methods:

• A randomized study of 46 patients undergoing HALC or LAC for benign or malignant disease.
• Evaluation of patient demographics, operative details, short-term outcomes, and associated costs.

Main Results:

• Short-term outcomes and patient characteristics were similar between the HALC and LAC groups.
• Hand-assisted laparoscopic colectomy (HALC) demonstrated a significantly lower conversion rate (4.7% vs. 28%, P=0.03).
• Surgical and total hospital costs were significantly higher in the HALC group ($1706.83±203.70 vs. $1304.93±305.67, P=0.038 and $2427.18±254.27 vs. $2044.03±215.22, P=0.021, respectively).

Conclusions:

• Hand-assisted laparoscopic colectomy (HALC) is associated with increased surgical and total hospital costs but a decreased rate of conversion.
• HALC may serve as a beneficial intermediate option between laparoscopic-assisted colectomy (LAC) and open surgery, potentially reducing the need for conversion.