Current Status of Hand-Assisted Laparoscopic Colorectal Surgery: A Review

Abstract

Most authors found hand-assisted laparoscopic colorectal surgery to be a very useful and promising technique. Suitable hand-insertion ports and laparoscopic instruments are crucial. Controlled trials demonstrate that the early benefits of the laparoscopic approach are realized and there may be a shorter learning curve.

Clinical Outcomes of 103 Hand-Assisted Laparoscopic Surgeries for Left-Sided Colon and Rectal Cancer: Single Institutional Review

“…However, the conversion rate is a less suitable variable for a HALS analysis, as conversion is required infrequently. The conversion rate in our study (2.7%) is less than the 3-12% conversion rate reported in other studies [16, 17]. …”

“…There have been a number of small reports on a HALS colectomy and 2 randomized controlled trials of a HALS colectomy compared with LC that only evaluated 74 HALS cases [16, 17]. When the short-term patient outcomes of a HALS colectomy and a LAC are compared, they are found to be similar [2, 16].…”

Hand‐assisted laparoscopic surgery may be a useful tool for surgeons early in the learning curve performing total abdominal colectomy

“…The median time to first bowel movement ( P = 0.15), rates of reoperation ( P = 0.48) and readmission ( P = 0.89) were also similar. The median LOS was 6 days (4–17) for open surgery group and was significantly longer than the LOS of the patients undergoing either hand assisted laparoscopic or straight laparoscopic total colectomy ( P = 0.0005) (Table 4).…”

Laparoscopic-Assisted or Laparoscopic-Facilitated Sigmoidectomy for Diverticular Disease? A Prospective Randomized Trial on Postoperative Pain and Analgesic Consumption

“…HALS was found to result in a significant reduction of operating times and to be equivalent regarding recovery of bowel activity, tolerance of diet, postoperative pain, and analgesic consumption. 8,25,26 Additionally, incisions necessary to accommodate the hand-device are smaller than the incisions we used in LFS.…”

“…The loss of the tactile sense and related difficulties with retraction (especially during mobilization of the left hemicolon), the dissection of mesentery, and the division of the bowel lumen make many surgeons feel more confident with an open approach. 8 Conversion to open surgery via a midline incision is associated with a significant increase in morbidity 9 -12 and impairment of the cosmetic result. In these situations, an alternative is to do only the difficult pelvic part of the operation conventionally, after the left hemicolon is mobilized laparoscopically.…”