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Related Experiment Video

Updated: Sep 8, 2025

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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[Hand-assisted Laparoscopic Surgery: experience with an original technique].

Carlos Vaccaro1, Marcos Gonzalez2, Tatiana Ruffa3

  • 1Hospital italiano de buenos aires. carlos.vaccaro@hospitalitaliano.org.ar.

Revista De La Facultad De Ciencias Medicas (Cordoba, Argentina)
|June 14, 2022
PubMed
Summary

Hand-assisted laparoscopic colorectal surgery (HALS) using a double-glove technique offers reduced operative time and lower conversion rates compared to standard laparoscopy (SL). Postoperative outcomes are comparable, particularly for complex procedures in obese patients.

Keywords:
colorectal surgerylaparoscopyoutcomes

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Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Surgery
  • Surgical Techniques

Background:

  • Hand-assisted laparoscopic surgery (HALS) traditionally requires specialized devices to maintain pneumoperitoneum.
  • A novel double-glove technique has been developed as an alternative to these devices for HALS.
  • Comparing HALS with this technique against standard laparoscopy (SL) is crucial for evaluating its clinical utility.

Purpose of the Study:

  • To compare the perioperative outcomes of patients undergoing hand-assisted laparoscopic colorectal surgery (HALS) using an original double-glove technique versus standard laparoscopic (SL) approach.

Main Methods:

  • Retrospective review of a prospective database of elective laparoscopic colorectal resections (2004-2020).
  • Analysis included logistic regression, propensity score matching, and inverse probability weighting to adjust for perioperative outcomes.
  • Comparison between HALS (n=458) and SL (n=1692) groups.

Main Results:

  • HALS demonstrated a significantly shorter operative time (170.3 vs 206.9 minutes, p<0.001), especially in obese, large, or complex cases, and for non-trained surgeons.
  • HALS was associated with a lower conversion rate (5% vs 9.9%, p<0.001; adjusted OR 0.45).
  • No significant differences were observed in hospital stay, morbidity, or readmission rates between the groups.

Conclusions:

  • The double-glove HALS technique is a viable alternative to SL, yielding comparable postoperative outcomes.
  • This HALS approach offers benefits of reduced operative time and lower conversion rates.
  • These advantages are particularly notable in complex procedures involving obese patients.