title: Hand-assisted laparoscopic surgery.
abstract: OBJECTIVE
  Hand-assisted laparoscopic surgery (HALS) has been proposed as a useful alternative to conventional open or laparoscopic surgery. However, most information is fragmented and comes from specific or selective indications. To assess the current situation of HALS, a general overview of the fields of application, results, and quality of the evidence of these results is necessary.
  
  
  METHODS
  Current English-language literature review.
  
  
  METHODS
  Case reports, series, and opinion articles on HALS.
  
  
  METHODS
  Evaluation of the type of study and results. Most of the articles are short case series. Only a few comparative or randomized comparative trials on HALS for splenectomy and colectomy have been published.
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic surgery seems to be a promising technique that has been applied with success in a wide range of digestive tract-related surgical procedures. The main role is to help in difficult cases before conversion is necessary or for training unskilled surgeons, and not as an alternative to pure laparoscopic surgery. However, not enough evidence-based data are available to know exactly the final outcome of this technique in general surgery. Prospective randomized trials with established open or laparoscopic procedures are lacking, and these trials are needed to support the final role of HALS.
authors.affiliation: Surgery Service, Hospital de la Santa Creu i Sant Pau, C/ Padre Claret 167, 08025 Barcelona, Spain. etargarona@hsp.santpau.es
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Targarona
authors.forename: Ester
authors.initials: E
authors.lastname: Gracia
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodriguez
authors.forename: Gemma
authors.initials: G
authors.lastname: Cerdán
authors.forename: Carmen
authors.initials: C
authors.lastname: Balagué
authors.forename: Jordi
authors.initials: J
authors.lastname: Garriga
authors.forename: Manuel
authors.initials: M
authors.lastname: Trias
mesh_terms: D003082:Colectomy / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D009392:Nephrectomy / Q000379:methods; D013156:Splenectomy / Q000379:methods