Hand-assisted laparoscopic surgery: an overview.
BACKGROUND
Advanced laparoscopic surgery is complex and time-consuming. Achieving consistent efficacy and safety throughout the entire procedure is always a problem. For this reason, hand-assisted laparoscopic surgery (HALS) was developed.


METHODS
Devices were designed to allow manual access to the abdomen through the utility laparotomy. By using one hand in the abdomen during laparoscopy, the surgeon regains direct tactile sensation and acquires improved hand-eye coordination. The safety of the individual devices has been tested in RCT for the registration of the individual devices. An index known as Surgical Action Efficiency was calculated for in six patients undergoing laparoscopic colon resection and six patients with hand-assisted colon resections.


RESULTS
All of the registered devices are safe. Surgical Action Efficiency for the laparoscopy group was 55 +/- 14%; for the HALS group, it was 71 +/- 4%. This result is statistically significant (p < 0.05).


CONCLUSIONS
HALS is a safe and efficient method by which it is possible to combine the established convenience and safety of open surgery with the advantages of minimally invasive surgery.
Meijer
D W
DW
Department of Experimental Surgery, Academic Medical Center, IWO Gebouw I-151, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Bannenberg
J J
JJ
Jakimowicz
J J
JJ
D006225:Hand; D006801:Humans; D010535:Laparoscopy / Q000379:methods*