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Hand-Assisted Laparoscopic Colectomy for Complicated Colorectal Disease in Emergency Settings.
Donghyoun Lee1, Yoon Hyung Kang2, Yongbog Kim3
1Department of Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea. (Drs. Lee and Chun).
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|September 8, 2025
Summary
Hand-assisted laparoscopy (HAL) is a feasible option for emergency colectomy in patients with American Society of Anesthesiologists scores I-III. This approach may offer benefits in specific surgical contexts for emergency colorectal surgery.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Laparoscopic colectomy's safety and effectiveness in emergencies are under investigation.
- Hand-assisted laparoscopy (HAL) offers potential advantages for emergency laparoscopic procedures.
- This study details the experience with emergency HAL colectomy.
Purpose of the Study:
- To evaluate the feasibility and outcomes of emergency hand-assisted laparoscopy (HAL) colectomy.
- To analyze patient demographics, surgical details, and postoperative results.
- To assess survival rates in malignancy cases.
Main Methods:
- Retrospective review of consecutive emergency colorectal cases treated with HAL colectomy.
- Analysis of patient demographics, indications, operative details, and outcomes.
- Inclusion of patients with American Society of Anesthesiologists (ASA) scores I-III.
Main Results:
- 50 patients underwent HAL colectomy for complicated colorectal disease (Feb 2015-Jul 2019).
- Common indications included obstruction (50%) and perforation (76%).
- Low open conversion rate (4%), median operative time 160 min, median blood loss 250 mL, median postoperative stay 12 days, complication rate 26%, and 2 mortalities.
Conclusions:
- Hand-assisted laparoscopy (HAL) is a feasible option for emergency colectomy in ASA I-III patients.
- HAL may provide benefits in specific surgical practice settings for emergency colorectal surgery.
- Further research can explore HAL's role in complex emergency abdominal procedures.
