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

Öztürk, Ersin; Kiran, Ravi P.; Remzi, Feza H.; Geisler, Daniel; Fazio, Victor W.

doi:10.1111/j.1463-1318.2009.01777.x

Cited by 26 publications

(17 citation statements)

References 22 publications

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“…4,[7][8][9][10][11][12]14,[20][21][22] However, proficiency, as opposed to competency, implies attainment of some level of mastery of the technique that comes with increased experience and results in improved outcomes rather than the bare minimum needed to complete an operation safely. Achieving proficiency associated with the technique appears to occur over a longer period and increased volume of cases.…”

Section: Commentmentioning

confidence: 99%

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

et al. 2012

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Section: Commentmentioning

confidence: 99%

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

et al. 2012

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“…Whereas hand-assisted laparoscopic surgery (HALS), a hybrid endoscopic technique incorporating elements of both laparoscopic and open techniques, can overcome these existing limitations. Since the first report in 1995 [8], HALS has been demonstrated more efficient than standard laparoscopic surgery as far as operating time and conversion rate were concerned [9–13], with oncological clearance comparable to open colorectal resection [14, 15]. However, to date, little solid evidence exists in support of HALS for mid and low rectal cancer in terms of locoregional recurrence and long-term survival outcomes.…”

Section: Introductionmentioning

confidence: 99%

Hand-assisted laparoscopic surgery compared with open resection for mid and low rectal cancer: a case-matched study with long-term follow-up

et al. 2015

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BackgroundThis study was designed to compare the long-term surgical outcomes of patients with mid and low rectal cancer after open or hand-assisted laparoscopic surgery (HALS).MethodsA case-matched controlled prospective analysis of 116 patients who underwent hand-assisted laparoscopic surgery (HALS) for stage I to III mid and low rectal cancer from 2005 to 2010 was performed. Contemporary patients who underwent open rectal surgery were matched to the HALS group at the ratio of 1:1. The perioperative clinical outcomes, postoperative pathology, and survival outcomes were compared between the groups.ResultsThe patient characteristics between the two groups were comparable. Ninety patients in the open group and 85 in the HALS group received sphincter-preserving surgery. HALS resulted in less blood loss and wound infection, faster return to oral diet, shorter postoperative hospital stay, and longer operating time. The two groups had similar complication rates. Lymph node retrieval and involvement of circumferential and distal margins were similar for both procedures. Cumulative incidences of locoregional recurrence, disease-free, or overall survival rates were statistically similar.ConclusionsThis study suggests that HALS for mid and low rectal cancer is acceptable in terms of short-term clinical outcomes and long-term survival results.

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“…Laparoscopic colorectal surgery was introduced in 1991 [12], which is usually associated with time-consuming, technically demanding, high conversion rate and has a long, steep learning curve [3,13,14], since surgeons need to handle a long mobile colon, and operate on multiple abdominal quadrants. Consequently, a new surgical procedure called HALS was introduced in the mid 1990s as a useful alternative to pure laparoscopic procedures [15].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, minimally invasive approaches, such as laparoscopic surgery, are widely accepted in general surgery and gradually becoming a preferred routine technique in colorectal surgery as well. The immediate benefits are obvious, but the disadvantages include loss of direct tactile sensation, hand-eye coordination during laparoscopic surgery and longer time for training, especially in extensive colorectal procedures such as total colectomy [3]. In 1994, Leahy et al [4] designed the hand-assisted devices for laparoscopic colon surgery, This hybrid operation allows the surgeon to introduce a hand into the abdominal cavity through a special hand port while maintaining the pneumoperitoneum [5].…”

Section: Introductionmentioning

confidence: 99%

The role of hand-assisted laparoscopic surgery in total colectomy for colonic inertia: a retrospective study

Wang

Lin

et al. 2013

J Korean Surg Soc

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PurposeTo compare and assess the efficacy, safety and utility of hand-assisted laparoscopic surgery (HALS) with open surgery (OS) in total colectomy with ileorectal for colonic inertia.MethodsFrom January 2001 to February 2012, 56 patients diagnosed with colonic inertia who failed to respond to medical treatments underwent hand-assisted laparoscopic total colectomy with ileorectal anastomosis. Another 68 patients underwent laparotomy. Main parameters such as clinical manifestations, conversion to open procedure, operative time, incision length, pain score, intraoperative blood loss, time to first flatus and hospitalization, early postoperative complications and hospitalization cost were retrospectively analyzed. Postoperative defecating frequencies were followed up in both groups.ResultsAll patients received successful operation, no surgical mortality happened and none of the patients required conversion to an exploratory laparotomy in HALS group. The clinical features, the estimated blood loss, incision length, pain score, first passing flatus time, and postoperative hospitalization time were superior in HALS group (P < 0.05). The early postoperative complications and frequency of defecation were similar. However, the mean operative time was longer and hospitalization cost was higher in HALS group than those in OS group (P < 0.05).ConclusionHALS total colectomy can be a safe and efficient technique in the treatment of colonic inertia. HALS can result in a better cosmetic result and a quicker postoperative recovery, but requires higher direct cost.

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

Abstract: Hand-assisted laparoscopic colectomy may be associated with a significantly shorter learning curve for TAC as results are better than early LC and comparable with LC performed by experienced laparoscopic surgeons. It may be a better option for surgeons early in their laparoscopic career.

Cited by 26 publications

References 22 publications

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

Hand-assisted laparoscopic surgery compared with open resection for mid and low rectal cancer: a case-matched study with long-term follow-up

The role of hand-assisted laparoscopic surgery in total colectomy for colonic inertia: a retrospective study

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